Individual
KELLY NICOLE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CRNA
Contact information
Practice address
11100 EUCLID AVE, ANESTHESIA DEPT, CLEVELAND, OH 44106-5007
(216) 844-7330
Mailing address
5687 WILSON MILLS RD, HIGHLAND HTS, OH 44143-3208
(440) 391-2478
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
123239
OH
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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