Provider Demographics
NPI:1679684450
Name:BLOUNT, ALEXIS MALPICA (RN, APRN-BC)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:MALPICA
Last Name:BLOUNT
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Gender:F
Credentials:RN, APRN-BC
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Mailing Address - Street 1:602 E MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2621
Mailing Address - Country:US
Mailing Address - Phone:410-684-3009
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC SPECIALTY CLINIC AMERICA BUILDING
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-400-1657
Practice Address - Fax:301-295-5069
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF333766-1363LF0000X
MDR162506363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD082NS845Medicare UPIN
DC003787M72Medicare UPIN