Black, Ivy
Black, Ivy is an individual health care provider with primary practice located at 4250 Brownsville Rd , Powder Springs GA 30127-2559. 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, Ivy can be contacted via phone (678) 567-8000.Contact Information
Primary practice address
4250 Brownsville Rd
Powder Springs GA 30127-2559
Phone: (678) 567-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN195496 | Georgia |
Profile Details
| NPI number | 1104571462 |
|---|---|
| LBN Legal business name | Black, Ivy |
| Credentials | C-NP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2022 |
| Last updated | Feb 15th, 2022 - about 3 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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