Debra Ann Blahnik

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

324130-31 Issued in WI

Practice address

9114 Reifs Mills Rd
Whitelaw, WI 54247-9724

Phone

(920) 901-9677

NPI assigned

Nov 24, 2019

Last updated

Nov 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574553600000",
    "number": "1679119788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9114 REIFS MILLS RD",
            "city": "WHITELAW",
            "state": "WI",
            "postal_code": "542479724",
            "telephone_number": "920-901-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9114 REIFS MILLS RD",
            "city": "WHITELAW",
            "state": "WI",
            "postal_code": "542479724",
            "telephone_number": "920-901-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAHNIK",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-24",
        "last_updated": "2019-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "324130-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Sue Brey, REGISTERED NURSE
• Renee Bernadette Debruin, DIPL. AC.
• Samantha Grathen, LPC-IT
• Kathryn Heinzen, LPC
• Sarah Lynn Kohel, RN

• Licensed Practical Nurse in Whitelaw, WI
• Providers in Whitelaw, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2019; 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.