Black, Laurie Jo
Black, Laurie Jo is an individual health care provider with primary practice located at 1200 6Th Ave N Centra Care Clinic, Saint Cloud MN 56303-2735. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Black, Laurie Jo can be contacted via phone (320) 251-2700.Contact Information
Primary practice address
1200 6Th Ave N Centra Care Clinic
Saint Cloud MN 56303-2735
Phone: (320) 251-2700
Fax: (727) 587-7739
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | ARNP2638602 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | R217274-5 | Minnesota |
Profile Details
| NPI number | 1679551329 |
|---|---|
| LBN Legal business name | Black, Laurie Jo |
| Credentials | RN CNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 4th, 2006 |
| Last updated | Nov 20th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679551329 | NPPES |
| Florida | MEDICAID | 0307418800 |
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