Gina Maria Blount, RN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Van, TX
NPI 1689624512 · NPPES record last updated Jul 10, 2007
Key facts
- NPI
- 1689624512
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 513569 (TX)
- Practice address
- 113 W Main St
Van, TX 75790-2883 - Phone
- (903) 963-8303
- Fax
- (903) 963-5863
- NPI assigned
- May 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130705000365 | TX | Order and Referring Only - Nurse Practitioner | 9436399953 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Texas Medical Center Quitman | Past | Accepting new patients | |
| East Texas Medical Center Quitman | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 513569 | TX | Yes |
Addresses
Primary practice location
113 W Main St
Van, TX 75790-2883
Mailing address
113 W Main St
Van, TX 75790-2883
Phone (903) 963-8303
Other providers in Van, TX
- Meagan Balbag
- Benjamin E Bunt DDS PLLC
- Brookshire Grocery Company
- Benjamin Edward Bunt
- Jose G Cano Jr.
- Country Inn Healthcare
- Angela Elske McFarland Davis
All providers in Van, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.