Black, Katy A

Black, Katy A is an individual health care provider with primary practice located at 211 E Main St , Carbondale KS 66414-9607. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Black, Katy A can be contacted via phone (785) 836-7111.

Contact Information

Primary practice address
211 E Main St Carbondale KS 66414-9607
Phone: (785) 836-7111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 76631 Kansas

Profile Details

NPI number 1043608920
LBN Legal business name Black, Katy A
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 31st, 2014
Last updated Mar 1st, 2024 - about last year

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 1043608920 NPPES
Kansas Other 068002294 MEDICARE
Kansas MEDICAID 201108160A MEDICARE

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