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Individual

ELLIE CATHARINE BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
5265 VISTA BLVD BLDG B, SPARKS, NV 89436-0836
(775) 352-5335
(775) 352-5334
Mailing address
2345 E PRATER WAY STE 207, SPARKS, NV 89434-9634
(775) 352-5335
(775) 352-5334

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
832783
NV
363LP2300X
Primary Care Nurse Practitioner
95014901
CA

Other

Enumeration date
10/07/2020
Last updated
04/16/2021
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