Healthcare Provider Details

I. General information

NPI: 1144909334
Provider Name (Legal Business Name): DEBORAH ANN ROSENBLOOM PHD, ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BRATTLEBORO RETREAT 1 ANNA MARSH LANE
BRATTLEBORO VT
05302
US

IV. Provider business mailing address

GREENFIELD COMMUNITY COLLEGE 1 COLLEGE DRIVE, OFFICE E 121D
GREENFIELD MA
01301
US

V. Phone/Fax

Practice location:
  • Phone: 802-258-3737
  • Fax: 802-258-3792
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number236448RN
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number236448NP
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: