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Individual

BLAMA SIRLEAF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BSN, RN

Contact information

Practice address
6594 S 35TH ST APT 201, FRANKLIN, WI 53132-8377
(414) 807-8387
Mailing address
6594 S 35TH ST APT 201, FRANKLIN, WI 53132-8377
(414) 807-8387

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
239864
WI

Other

Enumeration date
06/16/2018
Last updated
06/16/2018
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