Individual
BRENDAN BLACKWELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3200 PLEASANT VALLEY RD, WEST BEND, WI 53095-9274
(262) 836-7300
(262) 836-7301
Mailing address
3200 PLEASANT VALLEY RD, WEST BEND, WI 53095-9274
(262) 836-7300
(262) 836-7301
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6803
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902279474
—
WI
Enumeration date
11/05/2015
Last updated
04/10/2025
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