KIMBERLY LUCILLE BLACK (NPI# 1255878989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255878989 |
| Entity Type | Individual |
| Full Name | KIMBERLY LUCILLE BLACK |
| Credential | PMHNP |
| Practice Address |
411 3rd St Monett MO 65708-2008 |
| Mailing Address |
Po Box 100 Pierce City MO 65723-2100 |
| Practice Telephone | 4174761000 |
| Practice Fax Number | 4174761082 |
| Mailing Telephone | 4174761000 |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-02-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2017004149 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063997237 | Kimberly Rochelle Black | Counselor | 31 E Main Ave, Taylorsville, NC 28681-2540 | 2018-10-03 |
| 1962769919 | Kimberly Black | Speech-Language Pathologist | 32 Monmouth Pkwy, Monmouth Beach, NJ 07750-1129 | 2012-04-16 |
| 1619484839 | Kimberly Black | Behavior Technician | 3110 Camino Del Rio S Ste 307, San Diego, CA 92108-3832 | 2018-01-09 |
| 1174042634 | Kimberly Sue Black | Registered Nurse | 7150 Clearvista Dr, Indianapolis, IN 46256-1695 | 2017-09-15 |
| 1326415043 | Kimberly Black | Occupational Therapy Assistant | 2403 Battlefield Pkwy, Fort Oglethorpe, GA 30742-4033 | 2015-08-28 |
| 1821476235 | Kimberly Black | Marriage & Family Therapist | 913 Willow St Ste 103, San Jose, CA 95125-2380 | 2015-05-18 |
| 1043613318 | Kimberly Black | Hearing Instrument Specialist | 798 Downtowner Blvd, Ste A, Mobile, AL 36609-5424 | 2014-10-01 |
| 1518199728 | Kimberly G Black | Surgery | 10240 Park Meadows Dr, Lone Tree, CO 80124-5425 | 2009-08-20 |
| 1558522342 | Kimberly Black | Physical Therapist | 212 W 3rd St Sw, Rome, GA 30165-2802 | 2008-06-24 |
| Street Address |
411 3RD ST |
| City | MONETT |
| State | MO |
| Zip Code | 65708-2008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629112925 | Malinda Carol Wilczynski | Nurse Practitioner | 411 3rd St, Monett, MO 65708-2008 | 2007-02-19 |
| 1639739626 | Amy Health Herbst | Nurse Practitioner | 411 3rd St, Monett, MO 65708-2008 | 2019-06-20 |
| 1932610342 | Sierra Golubski | Registered Nurse | 411 3rd St, Monett, MO 65708-2008 | 2017-10-12 |
| 1891206207 | Megan Wilson | Licensed Practical Nurse | 411 3rd St, Monett, MO 65708-2008 | 2017-10-12 |
| 1740713841 | Nick Heeter | Registered Nurse | 411 3rd St, Monett, MO 65708-2008 | 2017-04-05 |
| 1386183036 | Teresa Arndt | Licensed Practical Nurse | 411 3rd St, Monett, MO 65708-2008 | 2017-02-14 |
| 1255873014 | Linley O'hara | Registered Nurse | 411 3rd St, Monett, MO 65708-2008 | 2016-11-10 |
| 1952852295 | Elena Silvers | Registered Nurse | 411 3rd St, Monett, MO 65708-2008 | 2016-10-21 |
| 1558812701 | Miranda Trout | Registered Nurse | 411 3rd St, Monett, MO 65708-2008 | 2016-10-21 |
| 1194276881 | Cristi Landoll | Registered Nurse | 411 3rd St, Monett, MO 65708-2008 | 2016-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927228 | Cox- Monett Hospital, Inc. | Family Medicine | 1000 E Hwy 60, Monett, MO 65708 | 2020-09-22 |
| 1629432182 | Clark Community Mental Health Center | Clinic/Center | 1701 N Central Ave, Monett, MO 65708 | 2016-04-11 |
| 1386010767 | Kathleen Josef Cook | Physical Therapist | 700 E. Cleveland Ave., Monett, MO 65708 | 2015-08-19 |
| 1427443829 | Jeremy Cash Graddy | Physical Therapist | 864 E Us Hwy 60, Suite A, Monett, MO 65708 | 2015-04-02 |
| 1871925529 | Kimberly K Mundt | Counselor | 1701 N Central Ave., Monett, MO 65708 | 2013-08-05 |
| 1114269776 | Amy J Cole | Counselor | 1701 N. Central, Monett, MO 65708 | 2013-03-21 |
| 1538444120 | Brenda Kay Barger-saunders | Respiratory Therapist, Certified | 807 North Lincoln Avenue, Asthma Education Program, Monett, MO 65708 | 2011-10-15 |
| 1164752622 | Clark Community Mental Health Center | Clinic/Center | 1701 North Central St, Monett, MO 65708 | 2010-01-06 |
| 1497918320 | Clark Community Mental Health Center | Counselor | 1701 North Central Ave, Monett, MO 65708 | 2008-07-10 |
| 1295929644 | Apex Physical Therapy, LLC | Clinic/Center | 100 Chapel Drive, Suite C, Monett, MO 65708 | 2007-08-29 |
| Find all providers in zip 65708 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629112925 | Malinda Carol Wilczynski | Nurse Practitioner | 411 3rd St, Monett, MO 65708-2008 | 2007-02-19 |
| 1639739626 | Amy Health Herbst | Nurse Practitioner | 411 3rd St, Monett, MO 65708-2008 | 2019-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1376152546 | Chijioke Francisca Mbah | Nurse Practitioner | 900 Sw 33rd St, Lees Summit, MO 64082-4191 | 2020-07-23 |
| 1740807825 | Aldijana Sacic | Nurse Practitioner | 8525 Glenwood Dr, Saint Louis, MO 63126-1849 | 2020-07-06 |
| 1639796766 | Courtney Paige Schult | Nurse Practitioner | 431 Stonewater Dr, Pevely, MO 63070-3210 | 2020-07-06 |
| 1912524059 | Farah Lynn Shaddix | Nurse Practitioner | 1103 Warm Winds Dr, O Fallon, MO 63366-6327 | 2020-07-05 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1215551973 | Nicole Lynn Parker | Nurse Practitioner | 1000 Jackson St Apt 1, Saint Charles, MO 63301-2676 | 2020-05-28 |
| 1386273217 | Andrea Morrow Wright | Nurse Practitioner | 8833 N Congress Ave Apt 813, Kansas City, MO 64153-1991 | 2020-04-03 |
| 1700413580 | Solange-belle Boma | Nurse Practitioner | 6326 Ne 44th St, Kansas City, MO 64117-1687 | 2020-03-24 |
| 1063044626 | Beatriz Fortaleza | Nurse Practitioner | 2305 South 65 Highway, Bldg A., Marshall, MO 65340-3702 | 2020-02-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.