Mrs Brenda Marie Black, LPN is a
Licensed Practical Nurse based in Reidsville, Georgia. Mrs Brenda Marie Black is licensed to practice in Georgia (license number LPN051788) and her current practice location is
150 Memorial Drive, 150 Memorial Drive, Reidsville, Georgia. She can be reached at her office (for appointments etc.) via phone at
(912) 557-6794.
NPI number for Mrs Brenda Marie Black is 1518122563 and her current mailing address is Po Box 818, 150 Memorial Drive, Reidsville, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1518122563.
Provider's Profile
| Full Name | Mrs Brenda Marie Black |
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| Gender | Female |
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| Speciality | Licensed Practical Nurse |
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| Location | 150 Memorial Drive, Reidsville, Georgia |
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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: 1518122563
- Provider Enumeration Date: 07/18/2008
- Last Update Date: 07/18/2008
Medical Identifiers
Medical identifiers for Mrs Brenda Marie Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1518122563 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | LPN051788 (Georgia) | 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. Mrs Brenda Marie 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 |
|---|
Mrs Brenda Marie Black, LPN
Po Box 818, 150 Memorial Drive,
Reidsville, GA 30453-0818
Ph: (912) 557-6794 | Mrs Brenda Marie Black, LPN
150 Memorial Drive, 150 Memorial Drive,
Reidsville, GA 30453
Ph: (912) 557-6794 |
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