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1255668208
KELLY M BLACKBURN
WAUKESHA, WI
NPI
1255668208
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WA0400X Registered Nurse, Addiction (Substance Use Disorder)
(Licence: WI 170106030)
Enumeration Date
2009-11-12
Last Update Date
2013-05-22
Business Address
-- KELLY M BLACKBURN RN
2422 N GRANDVIEW BLVD
WAUKESHA, WI 53188-6105
Phone number: 262-549-6600
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Mailing Address
-- KELLY M BLACKBURN RN
2422 N GRANDVIEW BLVD
WAUKESHA, WI 53188-6105
Phone number: 262-549-6600
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