Provider Demographics
NPI:1720378029
Name:OBLETZ, CYNTHIA B (CYNTHIA OBLETZ)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:B
Last Name:OBLETZ
Suffix:
Gender:F
Credentials:CYNTHIA OBLETZ
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:B
Other - Last Name:OBLETZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1906 E SHOREWOOD BLVD
Mailing Address - Street 2:UNITE 156
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2500
Mailing Address - Country:US
Mailing Address - Phone:414-562-9443
Mailing Address - Fax:
Practice Address - Street 1:1906 E SHOREWOOD BLVD
Practice Address - Street 2:UNIT 156
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-2500
Practice Address - Country:US
Practice Address - Phone:414-562-9443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI128748-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse