Individual
VALERIE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1218 W KILBOURN AVE, SUITE 301, MILWAUKEE, WI 53233-1330
(414) 276-6000
(414) 276-1758
Mailing address
1218 W KILBOURN AVE, SUITE 301, MILWAUKEE, WI 53233-1330
(414) 276-6000
(414) 276-1758
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
502
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42984700
—
WI
Enumeration date
05/26/2006
Last updated
11/23/2021
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