Blackburn, Kelly M
Blackburn, Kelly M is an individual health care provider with primary practice located at 2422 N Grandview Blvd , Waukesha WI 53188-6105. She recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Blackburn, Kelly M can be contacted via phone (262) 549-6600.Contact Information
Primary practice address
2422 N Grandview Blvd
Waukesha WI 53188-6105
Phone: (262) 549-6600
Fax: (262) 549-6698
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Addiction (Substance Use Disorder) | 163WA0400X | 170106030 | Wisconsin |
Profile Details
| NPI number | 1255668208 |
|---|---|
| LBN Legal business name | Blackburn, Kelly M |
| Credentials | Registered Nurse (RN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 12th, 2009 |
| Last updated | May 22nd, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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