Black, Jean Marie

Black, Jean Marie is an individual health care provider with primary practice located at 140 Christiansburg Pike , Floyd VA 24091-3742. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Black, Jean Marie can be contacted via phone (540) 745-9290.

Contact Information

Primary practice address
140 Christiansburg Pike Floyd VA 24091-3742
Phone: (540) 745-9290
Fax: (540) 745-9294
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024101703 Virginia

Profile Details

NPI number 1417938416
LBN Legal business name Black, Jean Marie
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated May 3rd, 2013 - about 13 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 1417938416 NPPES
Virginia MEDICAID 1194908491

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