Individual
CHRISTOPHER BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
13020 S FORT ST, DRAPER, UT 84020-9294
(801) 361-2225
Mailing address
1072 E 920 N, OREM, UT 84097-4327
(801) 361-2255
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9152128-4405
UT
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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