MEDICARE: NATALIE BLACK NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	71011533A	IN

General Provider Information

NPI Number	:	1114697000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE BLACK NP

Provider Business Mailing Address
First Line	:	3245 MOUNT MORIAH AVE STE 10
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42303-7834
Country	:	US
Telephone Number	:	270-663-0955
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 N GREEN RIVER RD STE 1
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-2942
Country	:	US
Telephone Number	:	812-901-5770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2021
Last Update Date	:	03/16/2026

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Directions to “ NATALIE BLACK NP” Practice Location

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