| NPI | 1669751079 |
|---|---|
| Former Name | KELLY RAE BLAZEK, HEMMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 11920-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 283) |
| 363L00000X Nurse Practitioner (Licence: MN R 147087-5) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 11920-33) | |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2022-11-11 |