Individual
CRYSTAL LYNN BLOOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
572 EXECUTIVE PL, FAYETTEVILLE, NC 28305-5585
(910) 864-8739
(910) 864-8222
Mailing address
572 EXECUTIVE PL, FAYETTEVILLE, NC 28305-5585
(910) 864-8739
(910) 864-8222
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
87767
NC
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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