Individual
LAURA LYNN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
990 OAK RIDGE TPKE, OAK RIDGE, TN 37830-6976
(865) 835-3010
Mailing address
PO BOX 5059, OAK RIDGE, TN 37831-5059
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
149799
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
15994
TN
Other
Enumeration date
08/23/2011
Last updated
09/24/2011
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