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Individual

MRS. SHARON MARIE BLOMDAHL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN/RCS

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
33596-031
WI

Other

Enumeration date
12/28/2009
Last updated
12/28/2009
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