Black, Carrie June

Black, Carrie June is an individual health care provider with primary practice located at 1756 E Center St , Madisonville KY 42431-2253. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Black, Carrie June can be contacted via phone (270) 821-3300.

Contact Information

Primary practice address
1756 E Center St Madisonville KY 42431-2253
Phone: (270) 821-3300
Fax: (270) 821-2100
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3002209 Kentucky

Profile Details

NPI number 1821195447
LBN Legal business name Black, Carrie June
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2006
Last updated Dec 8th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821195447 NPPES
Kentucky Other 2209P LICENSE
Kentucky Other 000000044303 LICENSE
Kentucky MEDICAID 78001153 LICENSE
Kentucky Other P00943823 LICENSE

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