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General NPI Number Information
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NPI Number | 1982184727
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Entity Type | Individual
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Provider Name | JULIE BLACK WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 8008 ROUTE 130 STE 305
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City | DELRAN
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State | NJ
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Zip | 08075-1869
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Country | US
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Telephone | 609-788-3195
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Fax |
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Provider Business Mailing Address
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Address Line | 8008 ROUTE 130 BLDG B
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City | DELRAN
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State | NJ
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Zip | 08075-1869
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Country | US
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Telephone |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 26NJ00858600
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License Number State | NJ
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