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Individual

KATHRYN BLUSKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3870
WI
363AM0700X
Medical Physician Assistant
PA00547
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0019171
RI MEDICARE
RI
01
11232010
BCBSRI
RI
01
12092010
NHPRI
RI
01
939025129
RI MEDICARE GROUP
RI
05
KB82936
RI
Enumeration date
03/18/2010
Last updated
09/29/2016
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