Individual
STACEY RAE BLACK
Active
Individual
STACEY RAE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
24464
NV
2085R0202X
Diagnostic Radiology Physician
45984
AZ
2085R0202X
Diagnostic Radiology Physician
64805
TN
2085R0204X
Vascular & Interventional Radiology Physician
24464
NV
2085R0204X
Vascular & Interventional Radiology Physician
45984
AZ
Other
Enumeration date
01/16/2007
Last updated
10/30/2025
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