Individual
SYDNEY LI BLAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1004 BLUEHILL AVE, FOND DU LAC, WI 54935-7602
(920) 904-4807
Mailing address
1004 BLUEHILL AVE, FOND DU LAC, WI 54935-7602
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
STUDENT
WI
Other
Enumeration date
10/03/2025
Last updated
10/24/2025
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