Black, Gladys E

Black, Gladys E is an individual health care provider with primary practice located at 441 N Wabash Ave , Marion IN 46952-2612. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Black, Gladys E can be contacted via phone (765) 660-6411.

Contact Information

Primary practice address
441 N Wabash Ave Marion IN 46952-2612
Phone: (765) 660-6411
Fax: (765) 651-7313
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 71002475Z Indiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71002475A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 71002475A Indiana

Profile Details

NPI number 1205011715
LBN Legal business name Black, Gladys E
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2008
Last updated Mar 27th, 2018 - about 6 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 1205011715 NPPES
Indiana MEDICAID 200982170
Indiana Other 000000645919

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