Laura Diane Black, F.N.P.
Individual provider Active NPI Nurse Practitioner · Arcata, CA
NPI 1851451579 · NPPES record last updated Oct 28, 2016
Key facts
- NPI
- 1851451579
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 7155 (CA)
- Practice address
- Humboldt State University
Arcata, CA 95521-8299 - Phone
- (707) 826-3146
- Fax
- (707) 826-5052
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7155 | CA | MD | Nurse Practitioner |
Interoperability endpoints
- laura.blacknp.p1@direct.ppnorcal.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 7155 | CA | Yes |
Addresses
Primary practice location
Humboldt State University
Arcata, CA 95521-8299
Mailing address
2001 Panorama Drive
Arcata, CA 95521-6800
Other providers in Arcata, CA
- Christine Marie Bernard
- Sarah Berry
- Birdsong Wellness, Inc.
- John Edward Biteman
- Marcella Bixler
- Tara Blaine
- Mary Susanne Blanco
- Steven Michael Blankman
- Kimberly Bloomfield
- Liam James Boardman
All providers in Arcata, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.