MS. Ryatisima Tishara Blue, LPN
NPI #1568720795 in Whitewater, Wisconsin
Provider Information
- NPI Number
- 1568720795
- Entity Type
- Individual
- Name
- MS. Ryatisima Tishara Blue, LPN
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Licensed Practical Nurse
- Credential
- LPN
- Enumeration Date
- Apr 25, 2012
- Last Updated
- Apr 25, 2012
Practice Location
- Address
- 1130 BLOOMINGFIELD DR APT 19
- City
- Whitewater
- State
- Wisconsin
- ZIP Code
- 53190-2652
- Phone
- (262) 215-3379
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Practical Nurse |
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