Individual
MS. WENDY RANEE BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
890 N 10TH ST, KALAMAZOO, MI 49009-6192
(888) 527-0012
(866) 519-1936
Mailing address
354 CEDAR DR, MICHIGAN CENTER, MI 49254-1271
(517) 962-1642
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703092968
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38-3411707
BEACON SPECIALIZED LIVING SERVICES
—
Enumeration date
07/26/2022
Last updated
07/26/2022
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