| NPI | 1396828992 |
|---|---|
| Former Name | JESSICA ANNE BLOOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WV 61450) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 73554) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-07-08 |