Black, Colleen Rochelle

Black, Colleen Rochelle is an individual health care provider with primary practice located at 6555 Kee Ln Ste 200 , Harrisburg NC 28075-7463. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Black, Colleen Rochelle can be contacted via phone (704) 316-6140.

Contact Information

Primary practice address
6555 Kee Ln Ste 200 Harrisburg NC 28075-7463
Phone: (704) 316-6140
Fax: (704) 316-6141
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2008-00927 North Carolina

Profile Details

NPI number 1508032194
LBN Legal business name Black, Colleen Rochelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2008
Last updated Oct 26th, 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 1508032194 NPPES
North Carolina MEDICAID 5916285

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