Individual
KELLY SUZANNE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
389 S SWING RD, GREENSBORO, NC 27409-2009
(479) 445-4033
Mailing address
7803 PERTHSHIRE DR, OAK RIDGE, NC 27310-8306
(479) 445-4403
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
212428
NC
Other
Enumeration date
01/23/2022
Last updated
01/23/2022
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