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LAURA ANN BLACK F.N.P.
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1346591104
Individual Registrant: LAURA ANN BLACK F.N.P.
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
717 CENTER ST HEALDSBURG, CA 95448-3604 US
Tel: 707-433-7258 Fax: --
Tel: 707-433-7258 Fax: --
Contact information for business:
717 CENTER ST HEALDSBURG, CA 95448-3604 US
Tel: 707-433-7258 Fax: --
Tel: 707-433-7258 Fax: --
Registration Information:
NPI: 1346591104
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | CA | 22370 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
