CARRIE JUNE BLACK (NPI# 1821195447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821195447 |
| Entity Type | Individual |
| Full Name | CARRIE JUNE BLACK |
| Credential | ARNP |
| Practice Address |
1756 E Center St Madisonville KY 42431-2253 |
| Mailing Address |
200 Clinic Dr Madisonville KY 42431-1661 |
| Practice Telephone | 2708213300 |
| Practice Fax Number | 2708212100 |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2015-01-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3002209 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | RAILROAD MEDICARE- WALMART MADISONVILLE | P00943823 | 01 |
| BCBS PROVIDER NUMBER | 000000044303 | 01 | |
| KY | LICENSE | 2209P | 01 |
| KY | 78001153 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972801876 | Carrie E Black | Physical Therapist | 111 Medical Center Blvd, Ste S-750, Marrero, LA 70072 | 2011-03-02 |
| 1467963033 | Carrie Sue Black | Speech-Language Pathologist | 6502 Slide Rd Ste 204, Lubbock, TX 79424-1311 | 2017-10-23 |
| 1225455314 | Carrie Black | Registered Nurse | 544 E Woodruff Ave, Toledo, OH 43604-5342 | 2014-03-26 |
| 1568661288 | Carrie Black | Plastic Surgery | 3000 Q St, Sacramento, CA 95816-7058 | 2007-07-12 |
| Street Address |
1756 E CENTER ST |
| City | MADISONVILLE |
| State | KY |
| Zip Code | 42431-2253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962417337 | Timothy Louis Gallagher | Pharmacist | 1756 E Center St, Madisonville, KY 42431-2253 | 2006-07-31 |
| 1184093494 | Samantha Jane Winebarger | Pharmacist | 1756 E Center St, Madisonville, KY 42431-2253 | 2015-09-16 |
| 1821398603 | Baptist Medical Management Services Inc | Internal Medicine | 1756 E Center St, Madisonville, KY 42431-2253 | 2010-10-27 |
| 1083931281 | Absolute Eye Care Plc | Optometrist | 1756 E Center St, Madisonville, KY 42431-2253 | 2010-04-27 |
| 1144310590 | Wal-mart Stores East, Lp | Technician/Technologist | 1756 E Center St, Madisonville, KY 42431-2253 | 2006-10-14 |
| 1659465169 | Patricia Kay Vespie | Nurse Practitioner | 1756 E Center St, Madisonville, KY 42431-2253 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750846309 | Sarah Davenport Ziegler | Registered Nurse | 3050 Nebo Rd, Madisonville, KY 42431 | 2019-02-08 |
| 1134604903 | Kelsey Dawn Wilson | Occupational Therapist | 425 Island Ford Rd, Madisonville, KY 42431 | 2018-09-27 |
| 1174006209 | Shaun Vickery | Physical Therapist | 425 Island Ford Road, Madisonville, KY 42431 | 2018-09-14 |
| 1881115384 | Filza Tajik | Speech-Language Pathologist | 1305-1 W. Noel Ave, Unit 1, Madisonville, KY 42431 | 2017-07-05 |
| 1245769280 | Susan Hart | Student in an Organized Health Care Education/Training Program | 200 Clinic Drive, Third North, Madisonville, KY 42431 | 2017-06-05 |
| 1811363880 | Cory Eakins | Nutritionist | 2223 S Main St, Madisonville, KY 42431 | 2015-08-13 |
| 1932598257 | Deidra Boyken | Counselor | 145 E. Center Street Suite 1d, Madisonville, KY 42431 | 2015-01-12 |
| 1841602398 | Jessica France | Occupational Therapist | 339 S Seminary St, Madisonville, KY 42431 | 2014-06-02 |
| 1497097562 | Sunrise Children's Services | Community/Behavioral Health | 1079 Thornberry Dr Ste 203, Madisonville, KY 42431 | 2013-03-26 |
| 1013275023 | Creasha King | Counselor | 1079 Thornberry Dr Ste B, Madisonville, KY 42431 | 2012-04-26 |
| Find all providers in zip 42431 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225636012 | Jennifer Castro Ledet | Nurse Practitioner | 689 English Oak Dr, Madisonville, LA 70447-3179 | 2020-10-14 |
| 1588273098 | Tamara Lynn Zelch | Nurse Practitioner | 142 Pine Loop Dr, Madisonville, TN 37354-6813 | 2020-07-30 |
| 1730706748 | Renee Hurley Christman | Nurse Practitioner | 28628 Venette Ct, Madisonville, LA 70447-3220 | 2020-06-25 |
| 1992329973 | Allison Newton Ravassipour | Nurse Practitioner | 110 Woodthrush Dr, Madisonville, LA 70447-4004 | 2020-06-04 |
| 1376926428 | Nacole Diaz | Nurse Practitioner | 633 Piney Ridge Cir, Madisonville, LA 70447-3101 | 2015-07-08 |
| 1407239890 | Christine Marie Talley | Nurse Practitioner | 238 Red Fox Run Blvd, Madisonville, LA 70447-3116 | 2015-07-02 |
| 1326487554 | Kaleidoscope Family Health, Inc. | Nurse Practitioner | 4900 New Highway 68, Madisonville, TN 37354-2142 | 2013-06-20 |
| 1124385257 | Ardith Elaine O'rourke | Nurse Practitioner | 57 J.e. Ellis Road, Madisonville, KY 42431 | 2012-04-13 |
| 1679751002 | Kelle Dawn Harper | Nurse Practitioner | 220 W Trinity St, Madisonville, TX 77864-1914 | 2008-02-07 |
| 1356384788 | Sheila M Gaia | Nurse Practitioner | 167 Warren St, Madisonville, TN 37354-3001 | 2006-06-14 |
| Find all providers in MADISONVILLE | ||||
| City | MADISONVILLE |
| Zip Code | 42431 |
Please comment or provide details below to improve the information on CARRIE JUNE 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.