Individual provider · NPI-1

Colleen Rae Black, MSN RNP CNM RN NP

Advanced Practice Midwife · Fresno, CA

NPI number1801879879
StatusActive
Last updated in NPPESOct 1, 2026

Details

NPI
1801879879
Entity type
Individual (NPI-1)
Name
Ms. Colleen Rae Black
Credential
MSN RNP CNM RN NP
Sex
Female
Sole proprietor
No
Enumeration date
Nov 23, 2005
Certification date
Oct 1, 2026
Last updated
Oct 1, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367A00000X Advanced Practice Midwife1129CAYes
363L00000X Nurse Practitioner6558CA

Practice location

2823 Fresno St
Fresno, CA 93721-1324

Phone 559-499-6540 · Fax 559-499-6541

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431

Phone 559-443-2682 · Fax 559-443-2681

Other practice locations

2823 Fresno St
Fresno, CA 93721-1324

Phone 559-499-6540

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