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Individual

MS. LORA LEE BLASIUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN APNP

Contact information

Practice address
161 WASHINGTON ST. SUITE 1400, EIGHT TOWER BRIDGE, CONSHOHOCKEN, PA 19428
(866) 825-3227
(484) 726-0013
Mailing address
PO BOX 900, WALES, WI 53183-0900
(262) 646-3341
(262) 646-8731

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2102033
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1114066701
NPI
WI
05
36027800
WI
Enumeration date
02/06/2007
Last updated
01/20/2011
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