Blanc, Carolyn
Blanc, Carolyn is an individual health care provider with primary practice located at 520 W 3Rd St , Kimberly WI 54136-1300. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Blanc, Carolyn can be contacted via phone (920) 788-7680.Contact Information
Primary practice address
520 W 3Rd St
Kimberly WI 54136-1300
Phone: (920) 788-7680
Fax: (920) 788-7688
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 40082 | Wisconsin |
Profile Details
| NPI number | 1790711620 |
|---|---|
| LBN Legal business name | Blanc, Carolyn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | Aug 24th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790711620 | NPPES |
| Wisconsin | Other | 005945003 | MEDICARE PTAN |
| Wisconsin | MEDICAID | 3256100 | MEDICARE PTAN |
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