Individual
MS. WILMALEAN MICHELLE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2506 39TH ST APT 68, MERIDIAN, MS 39305-3887
(601) 850-1012
Mailing address
2506 39TH ST APT 68, MERIDIAN, MS 39305-3887
(601) 850-1012
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
363L00000X
Nurse Practitioner
Primary
12361U4
MS
Other
Enumeration date
01/30/2024
Last updated
03/17/2026
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