Provider Demographics
NPI:1073620704
Name:BLOMELEY, HEATHER ILENE (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ILENE
Last Name:BLOMELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 SYLVAN LANE
Mailing Address - Street 2:P.O. BOX 190
Mailing Address - City:MILL SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:28756
Mailing Address - Country:US
Mailing Address - Phone:828-894-8940
Mailing Address - Fax:
Practice Address - Street 1:LRMC DEPARTMENT OF ANESTHESIOLOGY
Practice Address - Street 2:CMR 402
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180
Practice Address - Country:US
Practice Address - Phone:496-371-9464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP929207LP3000X
NC35590207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology