Individual
KRISTIN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7459 BURLINGTON PIKE, FLORENCE, KY 41042-1553
(859) 282-6585
Mailing address
502 FARRELL DR, COV, KY 41011-3717
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184607
MEDICARE GROUP NUMBER
KY
Enumeration date
06/22/2006
Last updated
07/08/2007
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