Provider Demographics
NPI:1831491471
Name:BLOOMFIELD, TERRI ANN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:TERRI
Middle Name:ANN
Last Name:BLOOMFIELD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:TERRI
Other - Middle Name:ANN
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:34 LAUREL HEIGHTS CT
Mailing Address - Street 2:
Mailing Address - City:HOWARD
Mailing Address - State:OH
Mailing Address - Zip Code:43028-9430
Mailing Address - Country:US
Mailing Address - Phone:614-205-6257
Mailing Address - Fax:
Practice Address - Street 1:34 LAUREL HEIGHTS CT
Practice Address - Street 2:
Practice Address - City:HOWARD
Practice Address - State:OH
Practice Address - Zip Code:43028-9430
Practice Address - Country:US
Practice Address - Phone:614-205-6257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN104691164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse