Individual
MS. JEAN MARIE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
140 CHRISTIANSBURG PIKE, FLOYD, VA 24091-3742
(540) 745-9290
(540) 745-9294
Mailing address
140 CHRISTIANSBURG PIKE, FLOYD, VA 24091-3742
(540) 745-9290
(540) 745-9294
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024101703
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194908491
—
VA
Enumeration date
11/08/2005
Last updated
05/03/2013
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