| Doctor Name: | MS. LORA LEE BLASIUS |
| NPI Number: | 1114066701 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN APNP |
| License Number: | 2102033 |
| Business Practice Address: | 161 Washington St. Suite 1400 Eight Tower Bridge Conshohocken, PA - 19428 |
| Business Phone Number: | 8668253227 |
| Business Fax Number: | 4847260013 |
| Mailing Address: | Po Box 900, WALES |
| State: | WI |
| Postal Code: | 531830900 |
| Phone Number: | 2626463341 |
| Fax Number: | 2626468731 |
| NPI Enumeration Date: | 02/06/2007 |
| NPI Last Update Date: | 01/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2102033 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |