BLOOM SKIN NUTRITION LLC NPI 1962924217

NPI Information

  • NPI: 1962924217
  • Provider Name: BLOOM SKIN NUTRITION, LLC
  • Classification: Point of Service - 305S00000X
  • Entity Type: Organization
  • Address: 14593 WINDWAY DR
    GRAND HAVEN, MI
    ZIP 49417
  • Phone: (636) 345-2375

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NPI Details

BLOOM SKIN NUTRITION, LLC is a point of service in Grand Haven, MI. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. BLOOM SKIN NUTRITION, LLC NPI is 1962924217. The provider is registered as an organization entity type.

The provider's business location address is:

14593 WINDWAY DR
GRAND HAVEN, MI
ZIP 49417-677
Phone: (636) 345-2375

The provider's authorized official is Heidi Paulsen .
The authorized official title is Practitioner / Owner and has the following contact phone number (636) 345-2375.

The enumeration date for this NPI number is 7/7/2017 and was last updated on 6/24/2025.

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
1305S00000XPoint of ServiceYes

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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