Provider Demographics
NPI:1326051541
Name:BLAAKMAN, SUSAN WALDBILLIG (NPP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:WALDBILLIG
Last Name:BLAAKMAN
Suffix:
Gender:F
Credentials:NPP
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF ROCHESTER SCHOOL OF NURSING
Mailing Address - Street 2:601 ELMWOOD AVE BOX SON
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF ROCHESTER PSYCH NURSING
Practice Address - Street 2:601 ELMWOOD AVENUE BOX 302
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-4314
Practice Address - Fax:585-273-1121
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF400631-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health