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Individual
MRS. JANICE D BLACK
Active
Individual
MRS. JANICE D BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN 619
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45834
RN LICENSE
SC
01
—
619
APN.RX
SC
Enumeration date
05/14/2007
Last updated
06/14/2021
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