Provider Demographics
NPI:1477674950
Name:BLOUNT, MARSHA L (CNP)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:L
Last Name:BLOUNT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:L
Other - Last Name:BIVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP
Mailing Address - Street 1:3333 BURNET AVE.
Mailing Address - Street 2:ML 11024
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:513-636-6771
Mailing Address - Fax:513-636-4615
Practice Address - Street 1:3333 BURNET AVE. ML 11024
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3039
Practice Address - Country:US
Practice Address - Phone:513-636-6771
Practice Address - Fax:513-636-4615
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 08699 NP363LP0200X
OHAPRN.CNP.08699363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics