Individual
AMANDA R BLOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1715 WOLF CIR, LAKE CHARLES, LA 70605-2353
(337) 480-7499
(337) 480-7498
Mailing address
PO BOX 122525 DEPT 2525, DALLAS, TX 75312-0001
(337) 494-2772
(337) 494-2928
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
218673
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
218673
STATE FNP LICENSE
LA
05
—
2571532
—
LA
Enumeration date
07/29/2021
Last updated
04/27/2022
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