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1760182893
KISHA RENEE BLACK
JACKSONVILLE, FL
NPI
1760182893
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL APRN11023957)
Enumeration Date
2023-03-07
Last Update Date
2023-03-07
Business Address
Ms. KISHA RENEE BLACK APRN
3625 UNIVERSITY BLVD. S.
JACKSONVILLE, FL 32216
Phone number: 904-702-6089
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Mailing Address
Ms. KISHA RENEE BLACK APRN
3612 DOUBLE BLANCH LANE
ORANGE PARK, FL 32073
Phone number: 904-536-3680
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