Individual
JENNIFER ANN BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
255 E PACES FERRY RD NE, ATLANTA, GA 30305-2233
(404) 671-4000
Mailing address
255 E PACES FERRY RD NE, ATLANTA, GA 30305-2233
(404) 671-4000
(515) 573-7898
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
126364
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159608
—
IA
01
—
07466
WELLMARK BC BS
IA
Enumeration date
12/07/2012
Last updated
11/30/2022
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