Individual
AMY JACQUELINE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
16525 HOLLY CREST LN STE 210, HUNTERSVILLE, NC 28078-4909
(704) 316-7760
(704) 316-7761
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-7760
(704) 316-7761
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5010060
NC
Other
Enumeration date
07/22/2008
Last updated
10/25/2022
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