Individual
MEGAN LYNNE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, AGNP-C
Contact information
Practice address
43 BAXTER BLVD, PORTLAND, ME 04101-1823
(207) 771-1717
Mailing address
68 PLEASANT ST, APT 2, PORTLAND, ME 04101-3967
(978) 257-3803
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
CNP161083
ME
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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