Provider Demographics
NPI:1003221672
Name:BLOUNT, XENIA T (ARNP)
Entity type:Individual
Prefix:
First Name:XENIA
Middle Name:T
Last Name:BLOUNT
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100224
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-7832
Mailing Address - Country:US
Mailing Address - Phone:352-273-7832
Mailing Address - Fax:352-273-7849
Practice Address - Street 1:PO BOX 100224
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-1865
Practice Address - Country:US
Practice Address - Phone:352-273-7832
Practice Address - Fax:352-273-7849
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9279940363L00000X
CT5759363LF0000X
FLAPRN11024536363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL117106800Medicaid