Maureen Black, RN

Primary specialty

Women's HospitalTaxonomy code 282NW0100X

License

290597-3102 Issued in UT

Practice address

5121 S Cottonwood St
Im Women and Children Administration 15400-15541
Murray, UT 84107-5701

Phone

(801) 507-7673

NPI assigned

Nov 3, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1528431335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3741 W 12600 S",
            "address_2": "MOM BABY UNIT",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657215",
            "telephone_number": "801-285-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "address_2": "IM WOMEN AND CHILDREN ADMINISTRATION 15400-15541",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-7673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MAUREEN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282NW0100X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Women",
            "state": "UT",
            "license": "290597-3102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "942854057",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Bissell
• Brittany Kay Bitters, LCSW
• Kendal Lena Bjella, RDN
• Atlanta Black
• Evan George Black, M.D.
• Benjamin W Blackburn, PA-C
• Charlene Blackburn, MOTR/L
• Jennifer Blackburn, LCSW
• Brenda K Blackham, MD
• Evelynn Blackham

• General Acute Care Hospital in Murray, UT
• Providers in Murray, UT by specialty
• General Acute Care Hospital in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.