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Individual

MR. JASON COREY BLOOMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSN, RN, CCRN, FANAI

Contact information

Practice address
502 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(575) 308-3787
(505) 843-8886
Mailing address
1412 PITT ST NE, ALBUQUERQUE, NM 87112-4240
(575) 308-3787
(505) 843-8886

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN-80349
NM
163WP2201X
Ambulatory Care Registered Nurse
RN-80349
NM

Other

Enumeration date
11/02/2023
Last updated
11/02/2023
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