Individual
MRS. ANDREA RENEE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5590 KIETZKE LN, RENO, NV 89511-3019
(775) 323-2080
(775) 683-9404
Mailing address
5590 KIETZKE LN, RENO, NV 89511-3019
(775) 323-2080
(775) 323-2334
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN001395
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093079998
—
NV
Enumeration date
06/26/2012
Last updated
01/29/2019
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