Organization
SJ BLACK ENTERPRISES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY BLACK NP (PRESIDENT)
(501) 413-8498
Entity
Organization
Contact information
Practice address
298 JEFFERY LN, CABOT, AR 72023-8576
(501) 413-8498
Mailing address
298 JEFFERY LN, CABOT, AR 72023-8576
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A001200
AR
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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