# LYNETTE BLOMBERG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1801203773
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WG0000X | General Practice Registered Nurse | 13-15205-062 | KS | Yes |
| 363LF0000X | Family Nurse Practitioner | 53-44340-062 | KS | — |

## Other

- **Enumeration date:** 07/12/2014
- **Last updated:** 07/12/2014