Provider Demographics
NPI:1245663624
Name:BLOMKALNS, PAUL (NP)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:BLOMKALNS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 HOUMA BLVD
Mailing Address - Street 2:FL 6
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2970
Mailing Address - Country:US
Mailing Address - Phone:504-454-4331
Mailing Address - Fax:504-454-4341
Practice Address - Street 1:4200 HOUMA BLVD
Practice Address - Street 2:FL 6
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2970
Practice Address - Country:US
Practice Address - Phone:504-454-4331
Practice Address - Fax:504-454-4341
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07513363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health