LAURIE JO BLACK

SAINT CLOUD, MN
NPI1679551329
Other NameLAURIE JO PEREIRA
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: MN  R217274-5)
Additional Taxonomies363LP0200X Nurse Practitioner, Pediatrics
(Licence: FL  ARNP2638602)
Enumeration Date2006-01-04
Last Update Date2014-11-20
Business Address
-- LAURIE JO BLACK RN CNP
1200 6TH AVE N CENTRA CARE CLINIC
SAINT CLOUD, MN 56303-2735
Phone number: 320-251-2700
Mailing Address
-- LAURIE JO BLACK RN CNP
1200 6TH AVE N CENTRA CARE CLINIC
SAINT CLOUD, MN 56303-2735
Phone number: 320-251-2700