Jackie Evans Black in Provo - Community Health
Jackie Evans Black - NPI 1629144308
Jackie Evans Black is a Community Health in Provo, Utah. Jackie Evans Black practices all healthcare services and medical treatments related to Community Health. The NPI Number for Jackie Evans Black is 1629144308. The last update date is 2007-07-09.
Jackie Evans Black's current location address is 151 S University Ave # 1900, Provo, Utah. You can contact this provider via phone number 8018517026 and fax number 8013438725. The mailing address for Jackie Evans Black is 151 S University Ave # 1900, Provo, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jackie Evans Black |
|---|---|
| Address | 151 S University Ave # 1900, Provo, Utah |
| Phone Number | 8018517026 |
| Fax Number | 8013438725 |
| Sole Proprietor | N |
| Credentials | RN |
NPI Number Detail
| NPI Number | 1629144308 |
|---|---|
| Provider Enumeration Date | 2006-11-27 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 151 S University Ave # 1900 |
|---|---|
| City | Provo |
| State | Utah (UT) |
| Post Code | 846014427 |
| Phone Number | 8018517026 |
| Fax Number | 8013438725 |
Provider's Primary Taxonomy Detail
| Speciality | Community Health |
|---|---|
| Taxonomy | 163Wc1500X |
| Licence No | 218040-3102 |
|
Definition: A registered nurse who improves the health of entire communities and populations. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 998877660009 | UT | -- | |
| QM0000039389 | UT | ALTIUS PROVIDER# | |
| 55102 | UT | PEHP PROVIDER # | |
| 103003506102 | UT | SELECT HEALTH PROVIDER # | |
| PR00489 | UT | -- | |
| 73-00012 | UT | UNITED HEALTHCARE ID# |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Jackie Evans Black by the Centers for Medicare & Medicaid Services?
The Jackie Evans Black has been assigned the NPI (National Provider Identifier) 1629144308 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Jackie Evans Black's physical address?
The Jackie Evans Black is physically located at 151 S University Ave # 1900, in the city of Provo, UT, with the postal code 846014427.
What is Jackie Evans Black's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Jackie Evans Black is Community Health, and the corresponding taxonomy classification code for this specialized field is 163Wc1500X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1629144308 to Jackie Evans Black?
The Centers for Medicare & Medicaid Services originally issued the 1629144308 to Jackie Evans Black on 2006-11-27.
As of what date were the Jackie Evans Black's details last updated?
The information pertaining to the Jackie Evans Black, including its address, specialty, and other details, was most recently updated on 2007-07-09.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC