Individual provider · Type 1 NPI
Kelly M. Blackburn, RN
Addiction (Substance Use Disorder) Registered Nurse · Waukesha, WI
NPI number
1255668208
Active
Practice location
2422 N Grandview Blvd
Waukesha, WI 53188-6105
Fax (262) 549-6698
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse Primary | 163WA0400X | 170106030 (WI) |
Addiction (Substance Use Disorder) Registered Nurse: Definition to come...
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About NPI 1255668208
Kelly M. Blackburn, RN's National Provider Identifier is 1255668208, issued on Nov 12, 2009. The primary taxonomy on file is Addiction (Substance Use Disorder) Registered Nurse (163WA0400X), and the practice location is in Waukesha, WI. The record was last updated on May 22, 2013.