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Timonthy Donell Black
Family Nurse Practitioner in Mount Airy, North Carolina
NPI 1992396022

Timonthy Donell Black is a Family Nurse Practitioner based in Stuart, NC and is specialized in Family. Timonthy Donell Black practices in Mount Airy, NC. The NPI Number for Timonthy Donell Black is 1992396022 and holds a License No. (North Carolina).

The current practice location address for Timonthy Donell Black is 113 Scenic Outlet Ln Ste 2, Mount Airy, NC and can be reached out via phone at 336-352-4900 and via fax at 336-352-4901.

Location: 113 Scenic Outlet Ln Ste 2, Mount Airy, NC, 24171-3769
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992396022
Provider Name
Timonthy Donell Black
Credential
Provider Entity Type
Individual
Gender
Male
Address
113 Scenic Outlet Ln Ste 2, Mount Airy, NC, 24171-3769
Phone Number
336-352-4900
Fax Number
336-352-4901
Provider Enumeration Date
02/01/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
113 Scenic Outlet Ln Ste 2
City
Mount Airy
State
North Carolina
Zip
27030-9978
Phone Number
336-352-4900
Fax Number
336-352-4901
person
Provider Business Mailing Address Details
Address
113 Scenic Outlet Ln Ste 2
City
Mount Airy
State
North Carolina
Zip
27030-9978
Phone Number
336-352-4900
Fax Number
336-352-4901
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
5014067 (North Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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