Individual
BRANDY LEE BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
81 HILLCREST DR, PUNXSUTAWNEY, PA 15767-2605
(814) 938-2064
Mailing address
81 HILLCREST DR, PUNXSUTAWNEY, PA 15767-2605
(814) 938-2064
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ARNP9313168
FL
363LF0000X
Family Nurse Practitioner
Primary
SP021533
PA
Other
Enumeration date
09/06/2017
Last updated
10/18/2023
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