Individual
AMBER DAWN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 S 9TH ST, TUCUMCARI, NM 88401-3281
(575) 461-3910
Mailing address
PO BOX 814, LOGAN, NM 88426-0814
(575) 403-6559
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
84272
NM
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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