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General NPI Number Information
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NPI Number | 1548809189
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Entity Type | Individual
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Provider Name | AMELIA KAYE BLOOMQUIST APRN
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Gender | Female
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Dates
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Enumeration Date | 12/30/2019
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 4305 E TRENT AVE
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City | SPOKANE
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State | WA
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Zip | 99212-1315
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Country | US
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Telephone | 800-491-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 4305 E TRENT AVE
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City | SPOKANE
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State | WA
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Zip | 99212-1315
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Country | US
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Telephone | 509-795-3133
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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 | 24710
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License Number State | SC
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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 | APRN.CNP.026114
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP61677784
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License Number State | WA
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