Amy Black, is a
Nurse Practitioner - Gerontology based in Chunchula, Alabama. Amy Black is licensed to practice in Alabama (license number 1-071140) and her current practice location is
10420 Reva Rd N, Chunchula, Alabama. She can be reached at her office (for appointments etc.) via phone at
(251) 490-5884.
NPI number for Amy Black is 1780239160 and her current mailing address is 10420 Reva Rd N, Chunchula, Alabama. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1780239160.
Provider's Profile
| Full Name | Amy Black |
|---|
| Gender | Female |
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| Speciality | Nurse Practitioner - Gerontology |
|---|
| Location | 10420 Reva Rd N, Chunchula, Alabama |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1780239160
- Provider Enumeration Date: 08/02/2019
- Last Update Date: 08/02/2019
Medical Identifiers
Medical identifiers for Amy Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780239160 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LG0600X | Nurse Practitioner - Gerontology | 1-071140 (Alabama) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amy Black is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Amy Black,
10420 Reva Rd N,
Chunchula, AL 36521-3330
Ph: (251) 490-5884 | Amy Black,
10420 Reva Rd N,
Chunchula, AL 36521-3330
Ph: (251) 490-5884 |
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