Individual
RUTH KRASZEWSKI BLOESL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC APNP
Contact information
Practice address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-2253
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
104965-030
WI
363L00000X
Nurse Practitioner
820-033
WI
363LF0000X
Family Nurse Practitioner
Primary
820-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43909200
—
WI
Enumeration date
10/03/2006
Last updated
02/17/2020
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