ETHAN RANDALL BLOMBERG NREMT-P NPI 1902740715

NPI Information

  • NPI: 1902740715
  • Provider Name: ETHAN RANDALL BLOMBERG, NREMT-P
  • Classification: Emergency Medical Technician, Paramedic - 146L00000X
  • Entity Type: Individual
  • Address: 6103 WICKHAM AVE
    FORT CAMPBELL, KY
    ZIP 42223
  • Phone: (715) 657-0985

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NPI Details

Ethan Randall Blomberg, NREMT-P is an emergency medical technician paramedic in Fort Campbell, KY. The provider is an EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards. Ethan Randall Blomberg, NREMT-P NPI is 1902740715. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6103 WICKHAM AVE
FORT CAMPBELL, KY
ZIP 42223-425
Phone: (715) 657-0985

The enumeration date for this NPI number is 4/14/2026 and was last updated on 4/14/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1146L00000XEmergency Medical Technician, ParamedicP032566GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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