Individual
JENNIFER ROBINSON BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4650 HARRISON BLVD, OGDEN, UT 84403-4303
(801) 475-3010
Mailing address
PO BOX 5546, DENVER, CO 80217-5546
(801) 475-3500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
338537-4405
UT
Other
Enumeration date
06/14/2023
Last updated
07/20/2023
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