Individual
SHERRY BLEECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
W6354 BRIAR LN, FORT ATKINSON, WI 53538-9342
(920) 650-7149
Mailing address
W6354 BRIAR LN, FORT ATKINSON, WI 53538-9342
(920) 650-7149
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
32462
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32462
—
WI
Enumeration date
03/15/2017
Last updated
03/15/2017
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