Individual
ELIZABETH R. BLAZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8303 DODGE ST, OMAHA, NE 68114
(402) 354-2917
(402) 354-3160
Mailing address
PO BOX 2797, OMAHA, NE 68103-2797
(402) 354-4230
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
79761
NE
363L00000X
Nurse Practitioner
Primary
112494
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538665161
—
IA
05
—
47037660432
—
NE
Enumeration date
04/03/2018
Last updated
10/11/2018
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