Individual
AMYLIA ASHLEY BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2300 E 30TH ST BLDG A, FARMINGTON, NM 87401-8991
(505) 564-2300
Mailing address
3208 N COCHITI AVE, FARMINGTON, NM 87401-2052
(435) 459-9881
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
90687
NM
Other
Enumeration date
10/21/2012
Last updated
01/13/2025
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