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MRS. BILLIE ANN BLACK FNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1508837782

Individual Registrant:
MRS. BILLIE ANN BLACK FNP
Gender: F
Sole Proprietor

Location and contact information for practice:
13963 MORSE ST  CEDAR LAKE, IN 46303-9639 US
Tel: 219-374-5555  Fax: 219-374-6669

Contact information for business:
13963 MORSE ST  CEDAR LAKE, IN 46303-9639 US
Tel: 219-374-5555  Fax: 219-374-6669

Registration Information:
NPI: 1508837782
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
IN71001186A

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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