Individual provider · Type 1 NPI

Laurie Jo Black, RN CNP

Pediatric Nurse Practitioner · St. Cloud, MN

NPI number 1679551329 Active

Practice location

1200 6th Ave N, Centra Care Clinic
St. Cloud, MN 56303-2735

Fax (727) 587-7739

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner 363LP0200XARNP2638602 (FL)
Pediatric Nurse Practitioner Primary 363LP0200XR217274-5 (MN)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1679551329

Laurie Jo Black, RN CNP's National Provider Identifier is 1679551329, issued on Jan 4, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in St. Cloud, MN. The record was last updated on Nov 20, 2014.