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BLOOM SKIN NUTRITION, LLC
NPI 1962924217
Point of Service in Grand Haven, MI

Active since July 07, 2017
14593 WINDWAY DR, GRAND HAVEN, MI 49417(636) 345-2375 Get Directions Write a Review

NPPES record last updated: June 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 24, 2025, Jul 21, 2022, Jul 10, 2017 and 1 more (4 updates tracked since 2017).

About Bloom Skin Nutrition, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLOOM SKIN NUTRITION, LLC (NPI 1962924217) is a healthcare organization registered as a point of service in Grand Haven, Michigan and active in the NPI registry since July 2017. The organization lists Heidi Paulsen, Practitioner / Owner, as its authorized official.

NPPES Registry Identity

NPI1962924217
Entity TypeOrganization
Primary Taxonomy305S00000X
Legal Business NameBLOOM SKIN NUTRITION, LLC
Location Address14593 WINDWAY DRGrand Haven, MI 49417-7677
Mailing Address14593 Windway DrGrand Haven, MI 49417-7677 · (636) 345-2375
Phone(636) 345-2375
Organization SubpartNo
Authorized OfficialHeidi PaulsenPractitioner / Owner · (636) 345-2375
Enumeration DateJuly 7, 2017
Last NPPES UpdateJune 24, 20254 updates tracked since enumeration
NPPES CertifiedJune 24, 2025
✔ NPI 1962924217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPoint of ServiceManaged Care Organizations
Taxonomy Code305S00000X
Definition
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.
14593 WINDWAY DR, Grand Haven, MI 49417
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEIDI PAULSEN RD, ATC
Dietitian, Registered
14593 WINDWAY DR
GRAND HAVEN, MI 49417
Ottawa County (636) 345-2375

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bloom Skin Nutrition, LLC's NPI number?

The NPI number for Bloom Skin Nutrition, LLC is 1962924217. It was assigned to this organization in the NPPES registry on July 7, 2017.

Where is Bloom Skin Nutrition, LLC located?

Bloom Skin Nutrition, LLC is located at 14593 Windway Dr, Grand Haven, MI 49417. The listed phone number is (636) 345-2375.

What is Bloom Skin Nutrition, LLC's specialty?

The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.

When was this NPI record last updated?

The NPPES record for Bloom Skin Nutrition, LLC was last updated on June 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.