Individual
BARBARA JANE BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
474 LITTERAL LN, ARGILLITE, KY 41121-8981
(606) 585-7211
Mailing address
474 LITTERAL LN, ARGILLITE, KY 41121-8981
(606) 585-7211
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
107020
WV
363LF0000X
Family Nurse Practitioner
0029777
OH
363LF0000X
Family Nurse Practitioner
3015487
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107020
APRN
WV
Enumeration date
11/04/2020
Last updated
10/27/2021
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