Individual
EVA MARIE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
376 COMMERCE AVE, CARROLLTON, AL 35447-2253
(205) 614-6228
(205) 367-1612
Mailing address
91 PHOENIX AVE, CARROLLTON, AL 35447-2351
(662) 549-4050
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-168015
AL
363LF0000X
Family Nurse Practitioner
901756
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-168015
ALABAMA LICENSE
AL
01
—
901756
MISSISSIPPI LICENSE
MS
Enumeration date
11/18/2019
Last updated
07/31/2025
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