Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Randall Blomberg, NREMT-P

Individual provider Paramedic · NPI 1902740715

Ethan Randall Blomberg, NREMT-P is a Paramedic in Fort Campbell, Kentucky. Licensed in Georgia. Registered with an NPI since 2026.

Licensed in
GA
In the registry since
2026

Practice location Address checks out

6103 Wickham Ave
Fort Campbell, KY 42223-5425
Phone: (715) 657-0985
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Paramedic (primary) Taxonomy 146L00000X · Licence P032566 (GA)

Record details

NPI number1902740715
Entity typeIndividual (Type 1)
GenderMale
Credentials NREMT-P
Sole proprietorNo
NPI enumeratedApril 14, 2026
Last updated in NPPESApril 14, 2026
Certification dateApril 14, 2026

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