Individual
MRS. MADISON BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7501 METCALF AVE, OVERLAND PARK, KS 66204-2927
(913) 642-6330
Mailing address
3515 W 73RD TER, PRAIRIE VILLAGE, KS 66208-2908
(816) 898-0782
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13-150204-042
KS
363LF0000X
Family Nurse Practitioner
Primary
53-82981-042
KS
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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