Individual
MRS. KELLY BLOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5603 DURALEIGH RD, SUITE 111, RALEIGH, NC 27612-2688
(919) 791-0840
(919) 791-0911
Mailing address
5603 DURALEIGH RD, SUITE 111, RALEIGH, NC 27612-2688
(919) 791-0840
(919) 791-0911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
103450
NC
Other
Enumeration date
06/16/2005
Last updated
12/12/2023
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