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General NPI Number Information
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NPI Number | 1225481369
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Entity Type | Individual
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Provider Name | CORTNEY BLACK NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 80 SUNSET DR
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City | ANNISTON
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State | AL
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Zip | 36207-6297
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Country | US
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Telephone | 256-591-1148
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Fax |
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Provider Business Mailing Address
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Address Line | 80 SUNSET DR
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City | ANNISTON
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State | AL
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Zip | 36207-6297
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Country | US
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Telephone | 256-591-1148
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 237092
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License Number State | GA
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