Active NPI
Laura Diane Black, F.N.P.
- Nurse Practitioner
- Arcata, CA
National Provider Identifier
1851451579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 7155
- Practice address
- Humboldt State University
Arcata, CA 95521-8299 - Phone
- (707) 826-3146
- Fax
- (707) 826-5052
- NPI assigned
- Dec 11, 2006
- Last updated
- Oct 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 7155 | CA | Primary |
Addresses
Primary practice location
Humboldt State University
Arcata, CA 95521-8299
Mailing address
2001 Panorama Drive
Arcata, CA 95521-6800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7155 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Interoperability endpoints
- laura.blacknp.p1@direct.ppnorcal.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477612800000",
"number": "1851451579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 PANORAMA DRIVE",
"city": "ARCATA",
"state": "CA",
"postal_code": "955216800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HUMBOLDT STATE UNIVERSITY",
"city": "ARCATA",
"state": "CA",
"postal_code": "955218299",
"telephone_number": "707-826-3146",
"fax_number": "707-826-5052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "LAURA",
"middle_name": "DIANE",
"name_prefix": "Ms.",
"credential": "F.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2016-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "7155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcata, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.