| NPI | 1023992203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER R BLOOMFIELD Pmhnp 260-610-3808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-08-01 |
| Last Update Date | 2025-08-14 |