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General NPI Number Information
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NPI Number | 1497849368
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Entity Type | Individual
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Provider Name | RUTH KRASZEWSKI BLOESL FNP-BC APNP
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 1821 S WEBSTER AVE
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City | GREEN BAY
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State | WI
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Zip | 54301-2253
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Country | US
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Telephone | 920-496-4700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19070
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City | GREEN BAY
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State | WI
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Zip | 54307-9070
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | 104965-030
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 820-033
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 820-33
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License Number State | WI
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