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Individual

MICHELLE BLOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
4020 MORSE XING, COLUMBUS, OH 43219-6037
(614) 472-8491
Mailing address
4020 MORSE XING, COLUMBUS, OH 43219-6037
(614) 472-8491

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
4704295279
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
RN.341314
OH

Other

Enumeration date
08/16/2011
Last updated
01/14/2016
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