person
Ivy Black, C-NP
Family Nurse Practitioner in Powder Springs, Georgia
NPI 1104571462

Ivy Black is a Family Nurse Practitioner based in Powder Springs, GA and is specialized in Family. Ivy Black practices in Powder Springs, GA and has the professional credentials of C-NP. The NPI Number for Ivy Black is 1104571462 and holds a License No. RN195496 (Georgia).

The current practice location address for Ivy Black is 4250 Brownsville Rd, Powder Springs, GA and can be reached out via phone at 678-567-8000.

Location: 4250 Brownsville Rd, Powder Springs, GA, 30127-1471
person
Provider Profile Details
NPI Number
1104571462
Provider Name
Ivy Black
Credential
C-NP
Provider Entity Type
Individual
Gender
Female
Address
4250 Brownsville Rd, Powder Springs, GA, 30127-1471
Phone Number
678-567-8000
Fax Number
Provider Enumeration Date
02/15/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4250 Brownsville Rd
City
State
Zip
30127-2559
Phone Number
678-567-8000
Fax Number
person
Provider Business Mailing Address Details
Address
4250 Brownsville Rd
City
State
Zip
30127-2559
Phone Number
678-567-8000
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
RN195496 (Georgia)
Definition
Definition to come...
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