Provider Demographics
NPI:1033577671
Name:BLOOM MIDWIFERY AND WOMENS HEALTH
Entity Type:Organization
Organization Name:BLOOM MIDWIFERY AND WOMENS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-832-8700
Mailing Address - Street 1:1440 WAKARUSA DR
Mailing Address - Street 2:STE 400
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-4090
Mailing Address - Country:US
Mailing Address - Phone:785-832-8700
Mailing Address - Fax:888-771-8229
Practice Address - Street 1:1440 WAKARUSA DR
Practice Address - Street 2:SUITE 400
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4090
Practice Address - Country:US
Practice Address - Phone:785-832-8700
Practice Address - Fax:888-771-8229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty