MRS. LISA ANNE BLACK (NPI# 1780944520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780944520 |
| Entity Type | Individual |
| Full Name | MRS. LISA ANNE BLACK |
| Credential | ARNP |
| Practice Address |
220 S Courtenay Pkwy Suite B Merritt Island FL 32952-4893 |
| Mailing Address |
Po Box 561600 Rockledge FL 32956-1600 |
| Practice Telephone | 3218685815 |
| Mailing Telephone | 3212590635 |
| Mailing Fax Number | 3214344642 |
| Enumeration Date | 2012-05-28 |
| Last Update Date | 2012-12-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP 2159422 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326396706 | Lisa Marie Black | Physical Therapy Assistant | 3433 Cranston Cir, Highlands Ranch, CO 80126-3620 | 2012-08-16 |
| 1659631240 | Lisa Black | Physical Therapist | 11524 Spaulding St, Omaha, NE 68164-2366 | 2012-05-17 |
| 1497086219 | Lisa Lynn Black | Midwife | 3917 Hickory Bend Trl, Mckinney, TX 75071-2776 | 2010-01-18 |
| 1871780387 | Lisa Gail Black | Massage Therapist | 525 13th Avenue, Huntington, WV 25701 | 2007-09-28 |
| 1386787661 | Lisa Myers Black | Psychologist | 4003 24th Ave Ne, Norman, OK 73071-7749 | 2007-02-15 |
| 1851484307 | Lisa Breaux Black | Family Medicine | 895 Verret St, Houma, LA 70360-4635 | 2006-10-02 |
| 1730152653 | Lisa B Black | Internal Medicine | 701 E Marshall St Ste 640, West Chester, PA 19380-4412 | 2006-02-10 |
| 1922607696 | Lisa Black | Home Health Aide | 1119 S New York Ave, Wellston, OH 45692-2427 | 2020-10-22 |
| 1720582398 | Lisa Black | Occupational Therapist | 7445 Allen Rd Ste 102, Allen Park, MI 48101-1992 | 2018-03-20 |
| 1609302678 | Lisa Black | Psychologist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2017-05-11 |
| Street Address |
220 S COURTENAY PKWY SUITE B |
| City | MERRITT ISLAND |
| State | FL |
| Zip Code | 32952-4893 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023432044 | Jenny Elizabeth Murdock | Social Worker | 220 S Courtenay Pkwy, Suite B, Merritt Island, FL 32952-4893 | 2014-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841761673 | Pushpa Daliya | Physical Medicine & Rehabilitation | 1200 S Courtenay Pkwy, Merritt Island, FL 32952 | 2018-12-05 |
| 1407335458 | Merritt Island Outpatient Surgery Center, LLC | Clinic/Center | 450 E Merritt Island Cswy Ste 400, Merritt Island, FL 32952 | 2018-08-10 |
| 1760903272 | Harold A Utt Jr. | Audiologist | 105 N. Banana River Drive, Merritt Island, FL 32952 | 2017-07-06 |
| 1942720982 | Cadiz Senior Care | Assisted Living Facility | 1970 Farrington Drive, Merritt Island, FL 32952 | 2017-06-21 |
| 1891230884 | Jessica Orcel | Behavioral Analyst | 1680 E. Central Avenue, Merritt Island, FL 32952 | 2016-12-29 |
| 1770039539 | Haley Haskins | Student in an Organized Health Care Education/Training Program | 1655 Yates Dr., Merritt Island, FL 32952 | 2016-08-31 |
| 1891150900 | Kristin Stevenson | Case Management | 262 Island Beach Blvd, Mirritt Island, FL 32952 | 2015-12-17 |
| 1568835080 | Brilliant Smiles Orthodontics | Health Maintenance Organization | 455 Magnolia Avenue, Merritt Island, FL 32952 | 2015-11-05 |
| 1184967184 | Roseann Judith Simone | Assisted Living Facility | 280 Bahama Dr, Angel Guardian, Cocoa Beach, FL 32952 | 2013-03-28 |
| 1942558861 | Daven H Patel | Dentist | 800 E. Merritt Island Causeway, Merritt Island, FL 32952 | 2012-08-27 |
| Find all providers in zip 32952 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568080422 | Shari Tillman | Nurse Practitioner | 1510 Monte Carlo Ct, Merritt Island, FL 32952-5666 | 2020-07-08 |
| 1487276853 | Marsel Kogan | Nurse Practitioner | 601 High Point Ct, Merritt Island, FL 32952-4177 | 2020-05-08 |
| 1760909766 | Trisha Lorraine White | Nurse Practitioner | 1021 Newfound Harbor Dr, Merritt Island, FL 32952-2759 | 2017-08-29 |
| 1295213346 | Mary Angela Mccarthy | Nurse Practitioner | 260 N Tropical Trl Ste 105, Merritt Island, FL 32953-4800 | 2018-07-31 |
| 1831604354 | Jean M Cervini-koby | Nurse Practitioner | 375 S Courtenay Pkwy, Merritt Island, FL 32952-4886 | 2017-12-06 |
| 1528582558 | Julieta Waldron | Nurse Practitioner | 255 Borman Dr, Merritt Island, FL 32953-3486 | 2017-08-01 |
| 1386038701 | Tiffany Bonnell | Nurse Practitioner | 270 N Sykes Creek Pkwy, Merritt Island, FL 32953 | 2015-03-24 |
| 1164721866 | Traci Lynn Futch-west | Nurse Practitioner | 40 Fortenberry Rd, Merritt Island, FL 32952-3616 | 2011-03-21 |
| 1760637201 | Kimberlee Ann Cavanaugh | Nurse Practitioner | 1500 E Merritt Island Cswy, Suite 300, Merritt Island, FL 32952-2612 | 2008-11-25 |
| 1780889899 | Dawn Jennifer Banke | Nurse Practitioner | 595 N Courtenay Pkwy, Suite 102, Merritt Island, FL 32953-4851 | 2007-06-19 |
| Find all providers in MERRITT ISLAND | ||||
| City | MERRITT ISLAND |
| Zip Code | 32952 |
Please comment or provide details below to improve the information on MRS. LISA ANNE BLACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.