Individual provider · Type 1 NPI

Tangella Black

Student in an Organized Health Care Education/Training Program · Conyers, GA

NPI number 1497165237 Active

Practice location

141 Ellis Dr
Conyers, GA 30012-8033

Call (407) 401-4764 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone 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 1497165237

Tangella Black's National Provider Identifier is 1497165237, issued on May 1, 2014. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Conyers, GA. The record was last updated on Feb 14, 2016.