OrganizationActive
Bloom Skin Nutrition, LLC
NPI 1962924217 · Point of Service · Grand Haven, MI
Provider details
- NPI number
- 1962924217
- Entity type
- Organization
- Primary specialty
- Point of ServiceManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Heidi Paulsen, Practitioner / Owner(636) 345-2375
Specialties & taxonomies
Managed Care Organizations
Practice location
14593 Windway Dr
Grand Haven, MI 49417-7677
Phone: (636) 345-2375
Approximate (ZIP-level) locationGet directions
Mailing address
14593 Windway Dr
Grand Haven, MI 49417-7677
Registry dates
- Enumerated
- 2017-07-07
- Last updated
- 2025-06-24
- Certified
- 2025-06-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.