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Individual

JENNIFER BLOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CPNP

Contact information

Practice address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(612) 813-6000
Mailing address
160 HILL CIR W, BIG LAKE, MN 55309-8821
(763) 464-4551

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
6506
MN

Other

Enumeration date
11/11/2019
Last updated
11/11/2019
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