Individual
MELANIE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1004 S ROCK ST, GEORGETOWN, TX 78626-5837
(512) 374-1876
(512) 371-8788
Mailing address
1106 SAN AUGUSTINE DR, AUSTIN, TX 78733-2562
(828) 423-4354
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
705859
TX
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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