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Individual

MS. LISA F BLOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NNP

Contact information

Practice address
8091 TOWNSHIP LINE RD, SUITE 207, INDIANAPOLIS, IN 46260-2494
(317) 415-7921
(317) 415-7922
Mailing address
8091 TOWNSHIP LINE RD, SUITE 207, INDIANAPOLIS, IN 46260-2494
(317) 415-7921
(317) 415-7922

Taxonomy

Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
71001121A
IN

Other

Enumeration date
09/10/2008
Last updated
09/10/2008
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