Black, Colleen Rochelle
Black, Colleen Rochelle is an individual health care provider with primary practice located at 6555 Kee Ln Ste 200 , Harrisburg NC 28075-7463. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Black, Colleen Rochelle can be contacted via phone (704) 316-6140.Contact Information
Primary practice address
6555 Kee Ln Ste 200
Harrisburg NC 28075-7463
Phone: (704) 316-6140
Fax: (704) 316-6141
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2008-00927 | North Carolina |
Profile Details
| NPI number | 1508032194 |
|---|---|
| LBN Legal business name | Black, Colleen Rochelle |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2008 |
| Last updated | Oct 26th, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508032194 | NPPES |
| North Carolina | MEDICAID | 5916285 |
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