Individual
MRS. AMY ELIZABETH BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
44 MEDICAL PARK BLVD STE A, PETERSBURG, VA 23805-9351
(804) 324-4511
(804) 835-5103
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001177817
VA
363L00000X
Nurse Practitioner
Primary
0024165724
VA
363LA2100X
Acute Care Nurse Practitioner
0024165724
VA
363LA2200X
Adult Health Nurse Practitioner
0024165724
VA
Other
Enumeration date
10/11/2006
Last updated
08/07/2024
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