Individual
MARIAH BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, MSN, FNP-C
Contact information
Practice address
24 NEWTON ST, SOUTHBOROUGH, MA 01772-1215
(443) 945-3295
Mailing address
5 NEPONSET ST, WORCESTER, MA 01606-2714
(508) 460-3250
(508) 453-8152
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2348576
MA
Other
Enumeration date
01/29/2025
Last updated
06/03/2025
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