Individual
CASANDRA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11514 HOMESTEAD DR, UPPER MARLBORO, MD 20774-5768
(240) 481-8616
Mailing address
11514 HOMESTEAD DR, UPPER MARLBORO, MD 20774-5768
(240) 481-8616
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN1037835
DC
Other
Enumeration date
11/15/2019
Last updated
11/15/2019
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