Provider Demographics
NPI:1730412214
Name:BLOOMFIELD, KAREN SHATKIN (MS, RN, CNS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:SHATKIN
Last Name:BLOOMFIELD
Suffix:
Gender:F
Credentials:MS, RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1877 PINE CONE CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-8932
Mailing Address - Country:US
Mailing Address - Phone:434-825-0974
Mailing Address - Fax:434-924-4576
Practice Address - Street 1:1877 PINE CONE CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-8932
Practice Address - Country:US
Practice Address - Phone:434-825-0974
Practice Address - Fax:434-924-4576
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0015000235364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult