Black, Colleen Rae

Black, Colleen Rae is an individual health care provider with primary practice located at 2823 Fresno St , Fresno CA 93721-1324. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Black, Colleen Rae can be contacted via phone (559) 499-6540.

Contact Information

Primary practice address
2823 Fresno St Fresno CA 93721-1324
Phone: (559) 499-6540
Fax: (559) 499-6541
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 6558 California
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 1129 California

Profile Details

NPI number 1801879879
LBN Legal business name Black, Colleen Rae
Credentials MSN RNP CNM RN NP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Dec 29th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801879879 NPPES
California Other 449993 REGISTERED NURSE
California Other 6558 REGISTERED NURSE
California Other 1129 REGISTERED NURSE

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