Blomgren, Sally Ann
Blomgren, Sally Ann is an sole proprietor health care provider with primary practice located at 78 Burncoat St , Worcester MA 01605-1350. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult, which is considered as her primary health care specialty. Blomgren, Sally Ann can be contacted via phone (508) 414-5469.Contact Information
Primary practice address
78 Burncoat St
Worcester MA 01605-1350
Phone: (508) 414-5469
Fax: (508) 870-7684
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult | 364SP0809X | 151021 | Massachusetts |
Profile Details
| NPI number | 1619067568 |
|---|---|
| LBN Legal business name | Blomgren, Sally Ann |
| Credentials | R.N. M.S. C.S. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 13th, 2006 |
| Last updated | Feb 26th, 2016 - about 9 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 | 1619067568 | NPPES |
| Massachusetts | Other | PN0758 | BLUECROSS/BLUE SHIELD |
| Massachusetts | Other | 2089549 | BLUECROSS/BLUE SHIELD |
| Massachusetts | Other | 1034280 | BLUECROSS/BLUE SHIELD |
| Massachusetts | Other | 411421 | BLUECROSS/BLUE SHIELD |
| Massachusetts | Other | 471005 | BLUECROSS/BLUE SHIELD |
| Massachusetts | Other | 7807539 | BLUECROSS/BLUE SHIELD |
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