Individual
BERNARDO BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
WSTF/NASA CLINIC, 12600 NASA ROAD BLDG. 104-E, LAS CRUCES, NM 88012-1298
(575) 524-5213
Mailing address
WSTF/NASA CLINIC, 12600 NASA ROAD BLDG. 104-E, LAS CRUCES, NM 88012-1298
(575) 524-5213
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
55487
NM
Other
Enumeration date
03/05/2019
Last updated
02/16/2024
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