Individual
MRS. JOHANNE BLOUNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
760 BROADWAY, BROOKLYN, NY 11206-5383
(718) 963-8000
Mailing address
13464 173RD ST FL 1, JAMAICA, NY 11434-4538
(718) 749-1061
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
309839
NY
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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