Individual
KAREN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
919 12TH PL STE 13, PRESCOTT, AZ 86305-1433
(928) 227-2967
Mailing address
919 12TH PL STE 13, PRESCOTT, AZ 86305-1433
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN147399
AZ
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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