# NORTHERN BLOOM HEALTH AND WELLNESS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285501593
- **Authorized official:** SAMANTHA GIBSON ANP-BC, APRN (OWNER)
- **Authorized official phone:** (907) 982-3285

## Contact information

- **Practice address:** 1901 N HEMMER RD APT 208, PALMER, AK 99645-9673
- **Practice address phone:** (907) 203-4677
- **Practice address fax:** (800) 516-0397
- **Mailing address:** 1901 N HEMMER RD APT 208, PALMER, AK 99645-9673
- **Mailing address phone:** (907) 203-4677
- **Mailing address fax:** (800) 516-0397

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/21/2025
- **Last updated:** 10/21/2025