Individual
JENNIFER BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
8910 BROAD ST SW, PATASKALA, OH 43062-7886
(740) 927-6705
Mailing address
1215 BROOKRIDGE DR, COLUMBUS, OH 43235-4004
(614) 582-3570
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.0033046
OH
Other
Enumeration date
03/27/2024
Last updated
03/30/2024
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