Doctor Name: | JANE BLOOM |
NPI Number: | 1386004075 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHDRNCS |
License Number: | RN100531 |
Business Practice Address: | 95 Golden Hill Lee, MA - 012389132 |
Business Phone Number: | 4132433336 |
Business Fax Number: | |
Mailing Address: | 95 Golden Hill, LEE |
State: | MA |
Postal Code: | 012389132 |
Phone Number: | 4132433336 |
Fax Number: | |
NPI Enumeration Date: | 02/24/2016 |
NPI Last Update Date: | 02/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0809X |
License Number: | RN100531 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health, Adult |
Taxonomy Definition: |