Individual provider · Type 1 NPI

Mackenzie Rose Vander Bloomen, MSN, FNP-C

Nurse Practitioner · Green Bay, WI

NPI number 1740940733 Active

Practice location

1860 Shawano Ave
Green Bay, WI 54303-2667

Call (920) 272-1010 Map

Mailing address

1326 Sand Acres Dr
De Pere, WI 54115-9487

Specialties and licenses

Taxonomy	Code	License
Registered Nurse	163W00000X	230930-30 (WI)
Nurse Practitioner Primary	363L00000X	11824-33 (WI)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1740940733

Mackenzie Rose Vander Bloomen, MSN, FNP-C's National Provider Identifier is 1740940733, issued on Dec 18, 2021. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Green Bay, WI. The record was last updated on Oct 13, 2022.