Individual
MS. HEATHER RONELLE BLOOMFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2100 N MAIN ST STE 304, CROWN POINT, IN 46307-1877
(574) 546-1900
(574) 546-1999
Mailing address
PO BOX 10299, FORT WAYNE, IN 46851-0299
(574) 546-1900
(574) 546-1999
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71008334A
IN
363LA2200X
Adult Health Nurse Practitioner
71008334A
IN
363LG0600X
Gerontology Nurse Practitioner
71008334A
IN
Other
Enumeration date
09/13/2018
Last updated
08/04/2020
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