Miranda A Black, LPN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

9674808 Issued in FL

Practice address

2230 Phoenix Ave
Jacksonville, FL 32206-3159

Phone

(904) 466-7339

NPI assigned

Jul 4, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1518703933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 W 30TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322093787",
            "telephone_number": "904-466-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 PHOENIX AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063159",
            "telephone_number": "904-466-7339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1985 W 30th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322093787",
            "country_code": "US",
            "telephone_number": "904-466-7339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MIRANDA",
        "middle_name": "A",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-04",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5169477",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9674808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kisha Renee Black, APRN
• Marvin Talmage Black, MS, LMHC
• Meghan Leigh Black, DNP
• Merticia Black
• Michelle Black, CRNA
• Narissa Black
• Natalie Deborah Black, APRN
• Trenye Black, LMHC
• Virginia Gibson Black, M.D.
• Angela Gonzales Blackburn, NURSE PRACTITIONER

• Registered Nurse in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.