Black, Theresa Ann

Black, Theresa Ann is an individual health care provider with primary practice located at 11 N Locust St , Buckhannon WV 26201-4707. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Black, Theresa Ann can be contacted via phone (304) 472-1600.

Contact Information

Primary practice address
11 N Locust St Buckhannon WV 26201-4707
Phone: (304) 472-1600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 49062 West Virginia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 49062 West Virginia

Profile Details

NPI number 1790982080
LBN Legal business name Black, Theresa Ann
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2007
Last updated Nov 29th, 2023 - about 2 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 1790982080 NPPES
West Virginia MEDICAID 3810009382

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