Bloom, Tracy Roy

Bloom, Tracy Roy is an sole proprietor health care provider with primary practice located at 1705 Georgia St , Napa CA 94559-1621. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Bloom, Tracy Roy can be contacted via phone (707) 738-3637.

Contact Information

Primary practice address
1705 Georgia St Napa CA 94559-1621
Phone: (707) 738-3637
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 616687 California
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 14057 California

Profile Details

NPI number 1699858357
LBN Legal business name Bloom, Tracy Roy
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2006
Last updated Oct 15th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699858357 NPPES
California Other CA131881 MEDICARE PTAN

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