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1083902316
MICHELLE M. BLACK
STATE COLLEGE, PA
NPI
1083902316
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: PA SP011489)
Enumeration Date
2011-07-20
Last Update Date
2018-08-07
Business Address
MICHELLE M. BLACK CRNP
120 RADNOR RD STE 100
STATE COLLEGE, PA 16801
Phone number: 814-231-7868
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Mailing Address
MICHELLE M. BLACK CRNP
120 RADNOR RD STE 100
STATE COLLEGE, PA 16801-7970
Phone number: 814-231-7868
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