SUSAN E BLAIR (NPI# 1861736399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861736399 |
| Entity Type | Individual |
| Full Name | SUSAN E BLAIR |
| Credential | NP |
| Practice Address |
34700 Valley Rd Oconomowoc WI 53066 |
| Mailing Address |
34700 Valley Rd Oconomowoc WI 53066-4500 |
| Practice Telephone | 8007674411 |
| Mailing Telephone | 8007674411 |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2016-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 5019 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
5019-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760752950 | Susan Marie Blair | Dietitian, Registered | 105 Dean Rd, Sterling, MI 48659-9796 | 2012-01-05 |
| 1649345745 | Susan B. Blair | Marriage & Family Therapist | 349 Main St Ste 1, Gaithersburg, MD 20878-5780 | 2006-11-22 |
| 1942209572 | Susan Diane Blair | Ophthalmology | 4200 N Rodney Parham Rd Ste 101, Little Rock, AR 72212-2458 | 2005-07-15 |
| 1255708640 | Susan Blair | Social Worker | 2307 W 6th St, Los Angeles, CA 90057-3119 | 2015-09-01 |
| 1508138942 | Susan B Blair | Marriage & Family Therapist | 1424 Summit Ave, Fort Worth, TX 76102-5912 | 2012-02-01 |
| 1013204387 | Susan Katherine Blair | Dentist | 201 N Arlington Heights Rd, Arlington Heights, IL 60004-6059 | 2011-07-06 |
| 1699818591 | Susan Blair | Physical Therapist | 2924 Brook Rd, Children's Hospital Credentialing Dept, Richmond, VA 23220-1215 | 2007-02-14 |
| 1790883684 | Susan Blair | Nurse Practitioner | 11801 South Fwy, Suite 338, Burleson, TX 76028-7021 | 2006-09-21 |
| 1992712319 | Susan M Blair | Pharmacist | 5 Main St, Queensbury, NY 12804-4007 | 2006-08-01 |
| 1104862754 | Susan Slocum Blair | Physical Therapist | 857 Center Ct, Shorewood, IL 60431-8520 | 2006-06-21 |
| Street Address |
34700 VALLEY RD |
| City | OCONOMOWOC |
| State | WI |
| Zip Code | 53066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518959436 | Bradley Christopher Riemann | Psychologist | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2005-08-17 |
| 1508477142 | Kiah Allen | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2020-08-16 |
| 1477183069 | Beth Marie Calvert | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2020-01-22 |
| 1609410364 | Lateisha Prescott | Registered Nurse | 34700 Valley Rd, Oconomowoc, WI 53066-4599 | 2019-11-05 |
| 1508342130 | Allison Ann Barton | Registered Nurse | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2018-07-17 |
| 1821503640 | Nicholas R Farrell | Psychologist | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2017-12-04 |
| 1699291757 | Laura Ann Heidelmeier | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2017-08-20 |
| 1508388927 | Hilary Kay Boyd | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2017-07-07 |
| 1275929051 | Nicholas Edward Mahoney | Psychiatry & Neurology | 34700 Valley Rd, Oconomowoc, WI 53066 | 2015-04-08 |
| 1013346725 | Jodi Tompitch | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2013-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376109082 | Sharon Legwinski | Occupational Therapist | 2195 N. Summit Way, Oconomowoc, WI 53066 | 2019-05-17 |
| 1033676390 | Paladina Health, LLC | Family Medicine | Paladina Health Oconomowoc Sentry Equipment Circle, 966 Blue Ribbon Circle N, Oconomowoc, WI 53066 | 2019-02-22 |
| 1689145500 | Oconomowoc Developmental Training Center of Wisconsin LLC | Residential Treatment Facility, Emotionally Disturbed Children | 36100 Genesee Lake School, Oconomowoc, WI 53066 | 2018-12-17 |
| 1649748203 | Ginny Dacquisto | Dietitian, Registered | 1134 Lily Rd, Oconomowoc, WI 53066 | 2018-11-12 |
| 1174000764 | Aimee M Metzger | Social Worker | 405 E Forest St Ste 113, Oconomowoc, WI 53066 | 2018-07-26 |
| 1023482569 | Forefront Dermatology, S.c. | Dermatology | 1320 Pabst Farms Cir, Suite 180, Oconomowoc, WI 53066 | 2015-11-20 |
| 1962890475 | Monica Rodriguez | Counselor | 405 East Forest Street, Suite 119, Oconomowoc, WI 53066 | 2015-01-06 |
| 1518384643 | Kimberley Bevan | Pharmacist | 1284 East Summit Avenue, Suite 100, Oconomowoc, WI 53066 | 2014-03-26 |
| 1699098905 | Heidi Eckroth Nunnemacher | Counselor | 35315 Genesee Lake Road, Oconomowoc, WI 53066 | 2010-03-02 |
| 1669705240 | Oconomowoc Development Training Center Ll | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3222 N. Silver Cedar Rd., Oconomowoc, WI 53066 | 2009-09-14 |
| Find all providers in zip 53066 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508477142 | Kiah Allen | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2020-08-16 |
| 1477183069 | Beth Marie Calvert | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2020-01-22 |
| 1043783590 | Cassandra Kneifl | Nurse Practitioner | 1205 Corporate Center Dr, Oconomowoc, WI 53066-4898 | 2019-01-08 |
| 1699291757 | Laura Ann Heidelmeier | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2017-08-20 |
| 1508388927 | Hilary Kay Boyd | Nurse Practitioner | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2017-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422726 | Wisconsin Healthcare Family Practices and Behavioral Services LLC | Nurse Practitioner | 10721 W Capitol Dr Ste G103, Wauwatosa, WI 53222-1210 | 2020-09-17 |
| 1689292856 | Julianne Margaret John | Nurse Practitioner | 3237 S 16th St Ste 310, Milwaukee, WI 53215-4526 | 2020-07-13 |
| 1356968002 | Marisa Hiley | Nurse Practitioner | W129 N7055 Northfield Drive, Menomonee Falls, WI 53051 | 2020-06-29 |
| 1932726700 | Lauren Marie Skemp | Nurse Practitioner | 1960 Hyview Rd, Cuba City, WI 53807-9718 | 2020-06-28 |
| 1235779240 | Conscious Practice, LLC | Nurse Practitioner | 119 19th St N, La Crosse, WI 54601-3724 | 2020-01-08 |
| 1073152161 | Stephanie L Ruskell | Nurse Practitioner | 3805 Spring St Ste 240, Mount Pleasant, WI 53405-1667 | 2020-01-06 |
| 1558924811 | Sarah Kathryn Garven | Nurse Practitioner | 5000 West National Ave Rm 3119, Milwaukee, WI 53295-1000 | 2019-04-22 |
| 1104394535 | Therese Ann Alm | Nurse Practitioner | 383 Williamstowne Ste 101, Delafield, WI 53018-2332 | 2018-11-03 |
| 1477079242 | Aeron Rachel Adams | Nurse Practitioner | W10237 Lake Emily Rd, Fox Lake, WI 53933 | 2017-08-14 |
| 1396140398 | Monica Gorski | Nurse Practitioner | 505 King St Ste 218, La Crosse, WI 54601-4289 | 2014-11-03 |
| Find all providers with the same taxonomy | ||||
| City | OCONOMOWOC |
| Zip Code | 53066 |
Please comment or provide details below to improve the information on SUSAN E BLAIR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.