Provider Demographics
NPI:1316251770
Name:BLOUNT, KULICIA HUBBARD (RN,BSN)
Entity type:Individual
Prefix:MRS
First Name:KULICIA
Middle Name:HUBBARD
Last Name:BLOUNT
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9883 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-2213
Mailing Address - Country:US
Mailing Address - Phone:504-416-3054
Mailing Address - Fax:504-242-9905
Practice Address - Street 1:9883 ANDOVER DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-2213
Practice Address - Country:US
Practice Address - Phone:504-416-3054
Practice Address - Fax:504-242-9905
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN093955163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse