Individual provider · Type 1 NPI

Molly Black

Certified Registered Nurse Anesthetist · Fort Polk, LA

NPI number 1114529674 Active

Practice location

1585 3rd St
Fort Polk, LA 71459-5102

Mailing address

43 Bassett St
Fort Bragg, NC 28307-2032

Other practice locations

  • 43 Bassett St, Fort Bragg, NC 28307-2032 · (210) 862-9692
  • 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011 · (503) 494-7641

Specialties and licenses

TaxonomyCodeLicense
Certified Registered Nurse Anesthetist 367500000X10041796 (OR)
Certified Registered Nurse Anesthetist Primary 367500000X971137 (TX)

Certified Registered Nurse Anesthetist: (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of creden…

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About NPI 1114529674

Molly Black's National Provider Identifier is 1114529674, issued on Nov 10, 2020. The primary taxonomy on file is Certified Registered Nurse Anesthetist (367500000X), and the practice location is in Fort Polk, LA. The record was last updated on Jul 8, 2025.