Healthcare Provider Details

I. General information

NPI: 1003221672
Provider Name (Legal Business Name): XENIA T BLOUNT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 100224
GAINESVILLE FL
32610-1865
US

IV. Provider business mailing address

PO BOX 100224
GAINESVILLE FL
32610-7832
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-7832
  • Fax: 352-273-7849
Mailing address:
  • Phone: 352-273-7832
  • Fax: 352-273-7849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9279940
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5759
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11024536
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: