Individual
SHELBY LYNN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1216 RYANS RD, WORTHINGTON, MN 56187-1780
(507) 372-6400
Mailing address
1161 170TH AVE, LUVERNE, MN 56156-4230
(605) 730-2095
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2464149
MN
Other
Enumeration date
01/27/2022
Last updated
07/15/2022
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