Individual
MS. MYRIA GUNN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2000 MEADE PKWY, SUFFOLK, VA 23434-4259
(757) 925-0759
Mailing address
2000 MEADE PKWY, SUFFOLK, VA 23434-4259
(757) 925-0759
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024169925
VA
Other
Enumeration date
06/18/2012
Last updated
07/11/2013
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