Individual
DIANNE M. BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903-4923
(401) 444-4000
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NPP37734
RI
363LF0000X
Family Nurse Practitioner
APRN01118
RI
Other
Enumeration date
01/15/2013
Last updated
12/05/2024
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