Individual
AMANDA N BLOOMFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11115 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 672-6443
(260) 672-6459
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71008766A
IN
363L00000X
Nurse Practitioner
APRN.CNP.0033057
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300024283
—
IN
Enumeration date
01/09/2019
Last updated
12/02/2025
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