Individual
MELISSA ANN BLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1640
Mailing address
324 5TH AVE S, SARTELL, MN 56377-1974
(320) 292-9428
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
804989
MN
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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