MEDICARE: MRS. ELAINE MARIE BLANK LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	17951-031	WI

General Provider Information

NPI Number	:	1720057243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELAINE MARIE BLANK LPN

Provider Business Mailing Address
First Line	:	7410 BOTTING RD
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53402-9742
Country	:	US
Telephone Number	:	126-268-1303
Fax Number	:

Provider Business Practice Location Address
First Line	:	7410 BOTTING RD
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53402-9742
Country	:	US
Telephone Number	:	126-268-1303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1518967470 — MR. RONALD L ALLEN MD
Practice Location Address:

4060 N MAIN ST
RACINE, WI
53402-3121

Practice Phone: 262-752-2020
Practice Fax:

1639179047 — DR. RICHARD JAY STULTZ DDS
Practice Location Address:

3900 N BAY DR
RACINE, WI
53402-3632

Practice Phone: 262-639-1600
Practice Fax:

1396728929 — MRS. JANE MARIE GROSS RN
Practice Location Address:

1625 4 1/2 MILE RD
RACINE, WI
53402-1805

Practice Phone: 262-681-9072
Practice Fax:

1780647917 — MRS. MICHELLE IRENE STABBE LPN
Practice Location Address:

8348 FOLEY RD
RACINE, WI
53402-9521

Practice Phone: 262-639-1648
Practice Fax:

1184682775 — DR. SARA KRISTEN NICHOLSON O.D.
Practice Location Address:

4060 N MAIN ST
RACINE, WI
53402-3121

Practice Phone: 262-752-2020
Practice Fax: 262-292-5019

1457395212 — TRANSITIONAL LIVING SERVICES, INC
Practice Location Address:

3710 DOUGLAS AVE
RACINE, WI
53402-3227

Practice Phone: 262-639-8084
Practice Fax: 262-639-8086

Directions to “ MRS. ELAINE MARIE BLANK LPN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.