# INDEPENDENT NURSE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245209196
- **Authorized official:** MS. SHARON MARIE BLOMDAHL LPN/RCS (VENTILATOR NURSE)
- **Authorized official phone:** (414) 525-0515

## Contact information

- **Practice address:** 11226 W JANESVILLE RD, HALES CORNERS, WI 53130-2401
- **Practice address phone:** (414) 525-0515
- **Mailing address:** 11226 W JANESVILLE RD, HALES CORNERS, WI 53130-2401
- **Mailing address phone:** (414) 525-0515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 33596031 | WI | Yes |

## Other

- **Enumeration date:** 03/14/2006
- **Last updated:** 08/22/2020