Individual provider · NPI-1

Julie J Black, FNP

Nurse Practitioner, Family · Middletown, NY

NPI number1992384218
StatusActive
Last updated in NPPESJun 10, 2021

Details

NPI
1992384218
Entity type
Individual (NPI-1)
Name
Julie J Black
Credential
FNP
Sex
Female
Sole proprietor
No
Enumeration date
Apr 5, 2021
Certification date
Jun 10, 2021
Last updated
Jun 10, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyF346743NYYes

Practice location

155 Crystal Run Rd
Middletown, NY 10941-4028

Phone 845-703-6999 · Fax 845-703-6297

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4028

Phone 845-703-6999 · Fax 845-703-6297

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