Individual
THERESA BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
6 E CHESTNUT ST STE 310, AUGUSTA, ME 04330-5760
(207) 623-2977
Mailing address
6 E CHESTNUT ST STE 310, AUGUSTA, ME 04330-5760
(207) 623-2977
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN74564
ME
363LP0200X
Pediatric Nurse Practitioner
Primary
CNP261085
ME
Other
Enumeration date
10/15/2025
Last updated
03/03/2026
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