Healthcare Provider Details

I. General information

NPI: 1689460339
Provider Name (Legal Business Name): TONIA BLOUNT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 IRON HORSE WAY
HANOVER MD
21076-2416
US

IV. Provider business mailing address

4405 WARNERS DISCOVERY WAY
BOWIE MD
20720-4894
US

V. Phone/Fax

Practice location:
  • Phone: 443-379-9093
  • Fax:
Mailing address:
  • Phone: 443-379-9093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License NumberRSA-02815
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberRSA-02815
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRSA-02815
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: