Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | ARNP9279940 | FL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 5759 | CT |
NPI | 1003221672 |
---|---|
Provider Name | Xenia T Blount |
First Address | Jacksonville, FL 32231-4004 |
Second Address | Jacksonville, FL 32207-8205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2014 |
Last Update Date | 01/08/2017 |