person
Freda Ann Black, NURSEPRACTITIONER
Adult Health Nurse Practitioner in South Bend, Indiana
NPI 1740296516

Freda Ann Black is an Adult Health Nurse Practitioner based in South Bend, IN and is specialized in Adult Health. Freda Ann Black practices in South Bend, IN and has the professional credentials of NURSEPRACTITIONER. The NPI Number for Freda Ann Black is 1740296516 and holds a License No. 209.005685 (Indiana).

The current practice location address for Freda Ann Black is 112 W Jefferson Blvd, South Bend, IN and can be reached out via phone at 574-546-1900 and via fax at 574-546-1999.

Location: 112 W Jefferson Blvd, South Bend, IN, 46601-1923
person
Provider Profile Details
NPI Number
1740296516
Provider Name
Freda Ann Black
Credential
NURSEPRACTITIONER
Provider Entity Type
Individual
Gender
Female
Address
112 W Jefferson Blvd, South Bend, IN, 46601-1923
Phone Number
574-546-1900
Fax Number
574-546-1999
Provider Enumeration Date
07/31/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
28104924A 01 IN RN LICENSE NUMBER
71001497A 01 IN APN LICENSE NUMBER
041.335636 01 IL RN LICENSE NUMBER
209.005685 01 IL APN LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
112 W Jefferson Blvd
City
State
Zip
46601-1923
Phone Number
574-546-1900
Fax Number
574-546-1999
person
Provider Business Mailing Address Details
Address
112 W Jefferson Blvd
City
State
Zip
46601-1923
Phone Number
574-546-1900
Fax Number
574-546-1999
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
209.005685 (Illinois)
Definition
Definition to come...
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