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General NPI Number Information
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NPI Number | 1144083486
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Entity Type | Organization
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Legal Business Name | BLOOM HEALTH NP
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Dates
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Enumeration Date | 01/31/2024
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 50 CITIZENS WAY STE 404
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City | FREDERICK
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State | MD
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Zip | 21701-6026
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Country | US
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Telephone | 410-835-4167
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Fax | 410-701-3766
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Provider Business Mailing Address
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Address Line | 50 CITIZENS WAY STE 404
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City | FREDERICK
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State | MD
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Zip | 21701-6026
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Country | US
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Telephone | 410-835-4167
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Fax | 410-701-3766
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Authorized Official
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Title or Position | OWNER
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Name | SHEILA ROHE
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Credential | NP
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Telephone | 410-835-4167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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