Black, Deborah L

Black, Deborah L is an individual health care provider with primary practice located at 2016 W 16Th St , Safford AZ 85546-4026. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Black, Deborah L can be contacted via phone (928) 428-1377.

Contact Information

Primary practice address
2016 W 16Th St Safford AZ 85546-4026
Phone: (928) 428-1377
Fax: (928) 348-8570
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 2394 Arizona

Profile Details

NPI number 1689744674
LBN Legal business name Black, Deborah L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2006
Last updated Jul 8th, 2007 - about 17 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 1689744674 NPPES
Arizona MEDICAID 636631

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