Individual
MRS. DIANA M. BLOOMBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED PRACTICAL N
Contact information
Practice address
2112 LIBERTY LANE, JANESVILLE, WI 53545-0548
(608) 755-9503
(608) 755-9513
Mailing address
2112 LIBERTY LANE, JANESVILLE, WI 53545-0548
(608) 755-9503
(608) 755-9513
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
32342-31
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39996300
—
WI
Enumeration date
01/27/2010
Last updated
01/27/2010
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