Healthcare Provider Details

I. General information

NPI: 1558273615
Provider Name (Legal Business Name): VA ZABLOCKI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W NATIONAL AVE
MILWAUKEE WI
53295-1000
US

IV. Provider business mailing address

21425 SPRING ST
UNION GROVE WI
53182-9707
US

V. Phone/Fax

Practice location:
  • Phone: 262-878-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: SARAH MICKEY
Title or Position: RN
Credential:
Phone: 262-878-7000