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Casandra Black

Registered Nurse in Upper Marlboro, MD. Individual provider (NPI-1).

NPI number1942845748
StatusActive
Last updated in NPPESNov 15, 2019

Details

NPI
1942845748
Entity type
Individual (NPI-1)
Name
Casandra Black
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 15, 2019
Last updated
Nov 15, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163W00000X Registered NurseRN1037835DCYes

Practice location

11514 Homestead Dr
Upper Marlboro, MD 20774-5768

Phone 240-481-8616

Mailing address

11514 Homestead Dr
Upper Marlboro, MD 20774-5768

Phone 240-481-8616

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