Ingrid Lea Bloomfield, Nurse Practitioner
Nurse Practitioner in Roswell, GA. Individual provider (NPI-1).
NPI number1457340978
StatusActive
Last updated in NPPESJul 31, 2020
Details
- NPI
- 1457340978
- Entity type
- Individual (NPI-1)
- Name
- Ms. Ingrid Lea Bloomfield
- Credential
- Nurse Practitioner
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 18, 2005
- Certification date
- Jul 31, 2020
- Last updated
- Jul 31, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 008355 | NY | Yes |
Practice location
4500 Hospital Blvd Ste 320Roswell, GA 30076-0001
Phone 770-410-4520
Mailing address
4500 Hospital Blvd Ste 320Roswell, GA 30076-0001
Phone 770-410-4520 · Fax 770-410-4525
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