Provider Demographics
NPI:1144083486
Name:BLOOM HEALTH NP
Entity type:Organization
Organization Name:BLOOM HEALTH NP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:410-835-4167
Mailing Address - Street 1:50 CITIZENS WAY STE 404
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6026
Mailing Address - Country:US
Mailing Address - Phone:410-835-4167
Mailing Address - Fax:410-701-3766
Practice Address - Street 1:50 CITIZENS WAY STE 404
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6026
Practice Address - Country:US
Practice Address - Phone:410-835-4167
Practice Address - Fax:410-701-3766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty