Provider Demographics
NPI:1194160788
Name:BLOMME, CHRISTINA (PHN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BLOMME
Suffix:
Gender:F
Credentials:PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 W MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-3169
Mailing Address - Country:US
Mailing Address - Phone:507-532-4139
Mailing Address - Fax:507-537-6719
Practice Address - Street 1:607 W MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-3169
Practice Address - Country:US
Practice Address - Phone:507-532-4139
Practice Address - Fax:507-537-6719
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 108299-1163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health