MEDICARE: ERICA L BLOOM PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	3356-23	WI

General Provider Information

NPI Number	:	1639587546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA L BLOOM PA-C

Provider Business Mailing Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-0001
Country	:	US
Telephone Number	:	715-838-5222
Fax Number	:

Provider Business Practice Location Address
First Line	:	733 W CLAIREMONT AVE
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54701
Country	:	US
Telephone Number	:	715-838-5222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2014
Last Update Date	:	06/08/2026

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