Individual
MRS. LAURIE ANN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP-C
Contact information
Practice address
2138 25TH ST STE F, COLUMBUS, IN 47201-3241
(812) 376-3100
(812) 378-6191
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
(812) 375-3477
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28200199A
IN
363LF0000X
Family Nurse Practitioner
Primary
71009191A
IN
Other
Enumeration date
05/11/2019
Last updated
05/08/2024
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