Independent Nurse

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

33596031 Issued in WI

Legal business name

INDEPENDENT NURSE

Practice address

11226 W Janesville Rd
Hales Corners, WI 53130-2401

Phone

(414) 525-0515

NPI assigned

Mar 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Sharon Marie Blomdahl, LPN/RCSNPI 1356671259

Title

Ventilator Nurse

Phone

(414) 525-0515

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sharon Marie Blomdahl, LPN/RCS

  • Licensed Practical Nurse
  • Hales Corners, WI
  • NPI 1356671259
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245209196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11226 W JANESVILLE RD",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302401",
            "telephone_number": "414-525-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11226 W JANESVILLE RD",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302401",
            "telephone_number": "414-525-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT NURSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLOMDAHL",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "VENTILATOR NURSE",
        "authorized_official_telephone_number": "414-525-0515",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPN/RCS"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WI",
            "license": "33596031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39951400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Hartl, DPT
• James P. Herman, D.D.S.
• Herslof'S, Inc
• Jacob Dean Hirtz, BCBA
• Katheryn Elizabeth Hurst, DPT
• Instep Physical Therapy, LLC
• J&K Home Care Services LLC
• Steven Joseph Jagemann, D.D.S.
• James C. Boudreau, DPM, SC
• Danielle Jones, LMT

• Adult Care Home Facility in Hales Corners, WI
• Providers in Hales Corners, WI by specialty
• Adult Care Home Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.