Most Relevant Information
Provider Data
| NPI Number: | 1003470279 |
| Provider Name: | EMILY JANE BLOOM NP |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 1-158499 |
Most Important Dates
| Enumeration Date: | 04/23/2019 |
| Last Updated: | 08/02/2021 |
Provider Practice Location
3419 COLONNADE PKWY STE 600
BIRMINGHAM
AL
352433337
Practice Location Phone/Fax
| Phone: | 2055986800 |
| Fax: | 2055986700 |
Provider Mailing Location
4916 PITTMAN AVE
IRONDALE
AL
352102514
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |