Individual provider · Type 1 NPI

Jackie Evans Black, RN

Community Health Registered Nurse · Provo, UT

NPI number 1629144308 Active

Practice location

151 S University Ave # 1900
Provo, UT 84601-4427

Call (801) 851-7026 Map

Fax (801) 343-8725

Mailing address

265 E 200 S
Salem, UT 84653-9452

Specialties and licenses

Taxonomy	Code	License
Community Health Registered Nurse Primary	163WC1500X	218040-3102 (UT)

Community Health Registered Nurse: Definition to come...

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Lisa Dorius, RNCommunity Health Registered Nurse Provo, UT NPI 1568538841
Margaret Frampton Warner, RNCommunity Health Registered Nurse Provo, UT NPI 1881761534
Marianne C. Lindsey, RNCommunity Health Registered Nurse Provo, UT NPI 1518033968
Marla J. Adams, RNCommunity Health Registered Nurse Provo, UT NPI 1659442267

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About NPI 1629144308

Jackie Evans Black, RN's National Provider Identifier is 1629144308, issued on Nov 27, 2006. The primary taxonomy on file is Community Health Registered Nurse (163WC1500X), and the practice location is in Provo, UT. The record was last updated on Jul 9, 2007.