Organization Active NPI

Branch and Bloom Psychiatry, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1609787456
Registry record updated Sep 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BRANCH AND BLOOM PSYCHIATRY, LLC
Practice address
2441 Myra Dr # 11
Cape Girardeau, MO 63703-5803
Phone
(573) 573-5203
Fax
(573) 908-7839
NPI assigned
Sep 12, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Kimberly Tunell Haber, PMHNP-BC
Title
Founder/Owner/Authorized Official
Phone
(573) 520-3484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2441 Myra Dr # 11
Cape Girardeau, MO 63703-5803

Mailing address

2441 Myra Dr # 11
Cape Girardeau, MO 63703-5803
Phone (573) 573-5203

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1789171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789171200000",
    "number": "1609787456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 MYRA DR # 11",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035803",
            "telephone_number": "573-573-5203",
            "fax_number": "573-908-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 MYRA DR # 11",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035803",
            "telephone_number": "573-573-5203",
            "fax_number": "573-908-7839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH AND BLOOM PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-12",
        "last_updated": "2026-09-12",
        "certification_date": "2026-09-12",
        "status": "A",
        "authorized_official_last_name": "HABER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "TUNELL",
        "authorized_official_title_or_position": "FOUNDER/OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "573-520-3484",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.