Most Relevant Information
Provider Data
| NPI Number: | 1003230764 |
| Provider Name: | MICHELLE MARIE BLOOM ACNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | 2015008056 |
Most Important Dates
| Enumeration Date: | 02/14/2014 |
| Last Updated: | 04/25/2024 |
Provider Practice Location
1 BARNES JEWISH HOSPITAL PLZ
DEPT ANESTHESIOLOGY
SAINT LOUIS
MO
631101003
Practice Location Phone/Fax
| Phone: | 8008629980 |
| Fax: | 3143621185 |
Provider Mailing Location
PO BOX 60352
SAINT LOUIS
MO
631600352
Provider Mailing Phone/Fax
| Phone: | 8008629980 |
| Fax: | 3143621185 |