Black, Theresa Marie
Black, Theresa Marie is an sole proprietor health care provider with primary practice located at 402 N Babcock St Ste 102 , Melbourne FL 32935-7335. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Black, Theresa Marie can be contacted via phone (321) 241-6540.Contact Information
Primary practice address
402 N Babcock St Ste 102
Melbourne FL 32935-7335
Phone: (321) 241-6540
Fax: (321) 428-4442
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | APRN11025876 | Florida |
Profile Details
| NPI number | 1164119269 |
|---|---|
| LBN Legal business name | Black, Theresa Marie |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 19th, 2023 |
| Last updated | Apr 19th, 2023 - 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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