| NPI | 1427541309 |
|---|---|
| Former Name | ADRIENNE BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012300) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 24174) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2021-10-18 |