Miranda Elizabeth Blajszczak, RN

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Practice address

2340 S Coffman Ave
Casper, WY 82604-3521

Phone

(307) 265-6698

NPI assigned

Jun 1, 2010

Last updated

May 31, 2011By 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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1679893655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 S COFFMAN AVE",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826043521",
            "telephone_number": "307-265-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 S COFFMAN AVE",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826043521",
            "telephone_number": "307-265-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAJSZCZAK",
        "first_name": "MIRANDA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-01",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WY",
            "license": "22824",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda M Blackdeer, CAP, BSW
• Jessica Blackman
• Kathy J Blair, PT
• Sarah Blair, CD(DONA)
• William Brent Blair
• Sarah Jo Blake, BSN
• Alecia Elaine Blakeley
• Samuel Aarin Blakeslee, RPH
• Jenfer Blatter, M.S.
• Brittany Blauvelt

• Developmentally Disabled Services Day Training Agency in Casper, WY
• Providers in Casper, WY by specialty
• Developmentally Disabled Services Day Training Agency in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.