Individual
TAMARA LYNN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
420 W 15TH AVE, EMPORIA, KS 66801-5367
(620) 342-4864
(620) 343-3545
Mailing address
420 W 15TH AVE, EMPORIA, KS 66801-5367
(620) 342-4864
(620) 343-3545
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
45728
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200332630B
—
KS
Enumeration date
07/03/2006
Last updated
02/02/2022
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