Provider Demographics
NPI:1326755547
Name:BLEWETT, WENDY SUE
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:SUE
Last Name:BLEWETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3765 RIDGEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:COLGATE
Mailing Address - State:WI
Mailing Address - Zip Code:53017-9396
Mailing Address - Country:US
Mailing Address - Phone:262-894-1123
Mailing Address - Fax:
Practice Address - Street 1:S31W24757 SUNSET DR
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53189-7014
Practice Address - Country:US
Practice Address - Phone:262-547-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2000-55171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist