Provider Demographics
NPI:1497311765
Name:BLOT, CHRISTINA KATHLEEN (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:KATHLEEN
Last Name:BLOT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-6644
Mailing Address - Country:US
Mailing Address - Phone:520-547-6178
Mailing Address - Fax:520-628-7222
Practice Address - Street 1:375 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-6644
Practice Address - Country:US
Practice Address - Phone:520-547-6178
Practice Address - Fax:520-628-7222
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ129100Medicaid