Individual
JENNIFER BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 W KENTUCKY AVE, PAMPA, TX 79065-3918
(806) 665-8801
Mailing address
1601 W KENTUCKY AVE, PAMPA, TX 79065-3918
(806) 665-8801
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
675268
TX
Other
Enumeration date
09/08/2007
Last updated
09/08/2007
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