Healthcare Provider Details

I. General information

NPI: 1932671443
Provider Name (Legal Business Name): ALLISON BLAZEK CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2018
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 W WISCONSIN AVE
MILWAUKEE WI
53226-4874
US

IV. Provider business mailing address

11410 7 1/8 MILE RD
FRANKSVILLE WI
53126-9716
US

V. Phone/Fax

Practice location:
  • Phone: 414-266-2000
  • Fax:
Mailing address:
  • Phone: 414-313-4260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number8872-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: