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1780944520
LISA ANNE BLACK
MERRITT ISLAND, FL
NPI
1780944520
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL ARNP 2159422)
Enumeration Date
2012-05-28
Last Update Date
2012-12-03
Business Address
Mrs. LISA ANNE BLACK ARNP
220 S COURTENAY PKWY SUITE B
MERRITT ISLAND, FL 32952-4893
Phone number: 321-868-5815
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Mailing Address
Mrs. LISA ANNE BLACK ARNP
PO BOX 561600
ROCKLEDGE, FL 32956-1600
Phone number: 321-259-0635
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