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General NPI Number Information
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NPI Number | 1053912212
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Entity Type | Individual
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Provider Name | BARBARA JANE BLOOM
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Gender | Female
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 474 LITTERAL LN
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City | ARGILLITE
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State | KY
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Zip | 41121-8981
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Country | US
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Telephone | 606-585-7211
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Fax |
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Provider Business Mailing Address
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Address Line | 474 LITTERAL LN
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City | ARGILLITE
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State | KY
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Zip | 41121-8981
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Country | US
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Telephone | 606-585-7211
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3015487
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0029777
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 107020
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License Number State | WV
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