Individual
MS. LAURA DIANE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
HUMBOLDT STATE UNIVERSITY, ARCATA, CA 95521-8299
(707) 826-3146
(707) 826-5052
Mailing address
2001 PANORAMA DRIVE, ARCATA, CA 95521-6800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7155
CA
Other
Enumeration date
12/11/2006
Last updated
10/28/2016
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