Individual
MS. CHRISTAN SHADEENE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-BC
Contact information
Practice address
2001 TODAYS WOMAN AVE, WINSTON SALEM, NC 27105-5069
(336) 722-1818
(336) 722-1826
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5018146
NC
363LG0600X
Gerontology Nurse Practitioner
2021103998
NC
Other
Enumeration date
07/13/2022
Last updated
06/25/2024
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