Bloom, Alida M.

Bloom, Alida M. is an individual health care provider with primary practice located at 2900 S National Ave , Springfield MO 65804-3634. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Bloom, Alida M. can be contacted via phone (417) 885-3888.

Contact Information

Primary practice address
2900 S National Ave Springfield MO 65804-3634
Phone: (417) 885-3888
Fax: (417) 881-7638
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 089317 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 089317 Missouri

Profile Details

NPI number 1841247228
LBN Legal business name Bloom, Alida M.
Credentials RN, CS, FNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2006
Last updated Jun 2nd, 2010 - about 15 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 1841247228 NPPES
Missouri Other 177827 ANTHEM BLUE CROSS/SHIELD
Missouri Other P01996 ANTHEM BLUE CROSS/SHIELD
Missouri Other 12432 ANTHEM BLUE CROSS/SHIELD
Missouri Other 1602599 ANTHEM BLUE CROSS/SHIELD
Missouri MEDICAID 502277007 ANTHEM BLUE CROSS/SHIELD

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