Individual
MELANIE ANNE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
2165 NW SHEVLIN PARK RD, BEND, OR 97703-7101
(541) 389-7741
Mailing address
PO BOX 1517, PENDLETON, OR 97801-0410
(877) 708-1119
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
101.0134595
VT
Other
Enumeration date
07/20/2020
Last updated
05/06/2025
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