Individual
LISA ANN BLAGDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 930-7107
(402) 930-7103
Mailing address
10245 BERRY ST, OMAHA, NE 68127-3037
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20758
NE
Other
Enumeration date
10/20/2025
Last updated
10/20/2025
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