Individual
CATHERINE R BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
280 RIVER PARK DR, SUITE 200, PROVO, UT 84604-5764
(801) 223-4860
(801) 371-8993
Mailing address
280 RIVER PARK DR, #200, PROVO, UT 84604-5764
(801) 223-4860
(801) 371-8993
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
198805-4405
UT
Other
Enumeration date
11/20/2007
Last updated
03/21/2014
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