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1083171284
TANYA THERESA IVEY-BLOOM
BALTIMORE, MD
NPI
1083171284
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MD R185746)
Enumeration Date
2019-02-23
Last Update Date
2019-10-20
Business Address
TANYA THERESA IVEY-BLOOM CRNP
600 N WOLFE ST
BALTIMORE, MD 21287-0005
Phone number: 410-955-7531
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Mailing Address
TANYA THERESA IVEY-BLOOM CRNP
600 N WOLFE ST
BALTIMORE, MD 21287-0005
Phone number: 410-955-7531
Copy
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