Provider Demographics
NPI:1336959436
Name:BLOUNT, SHILONDA
Entity type:Individual
Prefix:
First Name:SHILONDA
Middle Name:
Last Name:BLOUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2616
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77410-2616
Mailing Address - Country:US
Mailing Address - Phone:281-636-0360
Mailing Address - Fax:
Practice Address - Street 1:2900 AMES CROSSING RD
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-2498
Practice Address - Country:US
Practice Address - Phone:612-777-3867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA22011020355324183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician