Provider Demographics
NPI:1437324316
Name:BLACK, BARBARA D (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:D
Last Name:BLACK
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:4601 CHARLOTTE PARK DR
Mailing Address - Street 2:SUITE 390
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-1915
Mailing Address - Country:US
Mailing Address - Phone:704-529-6161
Mailing Address - Fax:704-323-7931
Practice Address - Street 1:114 HOLLOWELL RD
Practice Address - Street 2:
Practice Address - City:AULANDER
Practice Address - State:NC
Practice Address - Zip Code:27805-9634
Practice Address - Country:US
Practice Address - Phone:252-345-3791
Practice Address - Fax:252-345-0480
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2018-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA17666363LF0000X
NC5004617363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily