NPI 1174037220 · live from the CMS NPI Registry
Amy Bloom, RD
Dietitian, Registered in Grand Rapids, MI. National Provider Identifier 1174037220, active.
NPI record
| NPI | 1174037220 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 2060 East Paris Ave Se, Suite 100, Grand Rapids, MI 49546 |
| Practice phone | 616-956-6100 |
| Mailing address | 2060 E Paris Ave Se Ste 100, Grand Rapids, MI 49546 |
| Enumerated | November 28, 2017 |
| Last updated | November 28, 2017 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.