Individual
CATHERINE J BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, ARNP, CPNP
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 860-3080
Mailing address
5515 WEST 81ST TERRACE, PRAIRIE VILLAGE, KS 66208
(913) 649-0880
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
121959
MO
363LP0200X
Pediatric Nurse Practitioner
1341691052
KS
363LP0200X
Pediatric Nurse Practitioner
44615
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100342480A
—
KS
05
—
424641801
—
MO
Enumeration date
07/28/2006
Last updated
01/25/2016
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