Provider Demographics
NPI:1538352885
Name:BLACK, NATALIA TANISHA (MSN, FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:NATALIA
Middle Name:TANISHA
Last Name:BLACK
Suffix:
Gender:F
Credentials:MSN, FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 LITTLE ELM PKWY,
Mailing Address - Street 2:SUITE 100 PMB1061
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6673
Mailing Address - Country:US
Mailing Address - Phone:214-620-0184
Mailing Address - Fax:
Practice Address - Street 1:2701 LITTLE ELM PKWY,
Practice Address - Street 2:SUITE 100 PMB1061
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-6673
Practice Address - Country:US
Practice Address - Phone:214-620-0184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily