Individual provider · Type 1 NPI

Kennedy Black

Student in an Organized Health Care Education/Training Program · Bismarck, ND

NPI number 1023977840 Active

Practice location

7500 University Dr
Bismarck, ND 58504-9652

Call (701) 355-8030 Map

Mailing address

9005 Oak Dr
Bismarck, ND 58503-6539

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed
Physical Therapist 225100000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1023977840

Kennedy Black's National Provider Identifier is 1023977840, issued on Jan 17, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Bismarck, ND. The record was last updated on Jan 17, 2026.