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Individual

STEPHANIE BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1979 BOWLES AVE, CREEDMOOR, NC 27522-7824
(919) 529-4530
Mailing address
1979 BOWLES AVE, CREEDMOOR, NC 27522

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
209094
NC

Other

Enumeration date
08/18/2014
Last updated
08/18/2014
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