Provider Demographics
NPI:1922306562
Name:BLOUNT, CHRISTY ANNE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:ANNE
Last Name:BLOUNT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3493 VETERANS DR N
Mailing Address - Street 2:SUITE C
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-6227
Mailing Address - Country:US
Mailing Address - Phone:731-986-2933
Mailing Address - Fax:731-986-2938
Practice Address - Street 1:3493 VETERANS DR N
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-6227
Practice Address - Country:US
Practice Address - Phone:731-986-2933
Practice Address - Fax:731-986-2938
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN15603363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1523046Medicaid
TN103G703632OtherMEDICARE GROUP
TN1523966OtherMEDICAID GROUP
TN103I508079Medicare PIN