Individual
MRS. BRENDA BLUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
5900 S LAKE DR, CUDAHY, WI 53110-3171
(414) 489-9000
Mailing address
420 W MICHIGAN ST, PORT WASHINGTON, WI 53074-2101
(414) 766-1044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4877
WI
363LF0000X
Family Nurse Practitioner
4877-33
WI
Other
Enumeration date
07/18/2012
Last updated
12/13/2021
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