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Individual
MS. COLLEEN RAE BLACK
Active
Individual
MS. COLLEEN RAE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN RNP CNM RN NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
6558
CA
367A00000X
Advanced Practice Midwife
Primary
1129
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1129
NURSE MIDWIFE
CA
01
—
449993
REGISTERED NURSE
CA
01
—
6558
NURSE PRACTITIONER
CA
Enumeration date
11/23/2005
Last updated
10/01/2026
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