Individual
MICHELLE R BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
427 US 31W BYP, BOWLING GREEN, KY 42101-1703
(270) 796-8800
(270) 796-9328
Mailing address
PO BOX 90039, BOWLING GREEN, KY 42102-9039
(270) 796-8800
(270) 796-9328
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3003025
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78003662
—
KY
Enumeration date
09/25/2006
Last updated
04/02/2014
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