Individual
BARRIE BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
516 NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1254
(505) 722-1487
Mailing address
516 NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1254
(505) 722-1487
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
168153
CO
Other
Enumeration date
04/26/2010
Last updated
04/26/2010
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