Provider Demographics
NPI:1053786657
Name:BLOUNT, ELIZABETH HAMLIN (NP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:HAMLIN
Last Name:BLOUNT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:LIZ
Other - Middle Name:HAMLIN
Other - Last Name:BLOUNT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-934-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08678363LF0000X
AL1-168949363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2411578Medicaid
MS03505779Medicaid
LA2411578Medicaid