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General NPI Number Information
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NPI Number | 1831231315
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Entity Type | Individual
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Provider Name | SHIRLEY HANLEY BLACK ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 300 W NORTH ST
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City | SEDAN
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State | KS
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Zip | 67361-1051
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Country | US
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Telephone | 620-725-3818
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Fax | 620-725-5433
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Provider Business Mailing Address
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Address Line | 501 WALNUT P.O. BOX 578
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City | CEDAR VALE
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State | KS
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Zip | 67024
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Country | US
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Telephone | 620-758-2221
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Fax | 620-758-2468
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 45993
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License Number State | KS
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