Individual
ABRA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5908 E STOP 11 RD, INDIANAPOLIS, IN 46237-8683
(317) 497-6800
(317) 497-6801
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71008181A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71008181A
INDIANA STATE BOARD OF NURSING
IN
Enumeration date
07/31/2018
Last updated
09/06/2024
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