1144909334 NPI number — DR. DEBORAH ANN ROSENBLOOM PHD, ACNP-BC

Table of content: DR. DEBORAH ANN ROSENBLOOM PHD, ACNP-BC (NPI 1144909334)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144909334 NPI number — DR. DEBORAH ANN ROSENBLOOM PHD, ACNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSENBLOOM
Provider First Name:
DEBORAH
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, ACNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144909334
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
GREENFIELD COMMUNITY COLLEGE
Provider Second Line Business Mailing Address:
1 COLLEGE DRIVE, OFFICE E 121D
Provider Business Mailing Address City Name:
GREENFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BRATTLEBORO RETREAT
Provider Second Line Business Practice Location Address:
1 ANNA MARSH LANE
Provider Business Practice Location Address City Name:
BRATTLEBORO
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-258-3737
Provider Business Practice Location Address Fax Number:
802-258-3792
Provider Enumeration Date:
07/14/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  236448RN , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2100X , with the licence number: 236448NP , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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