MARY ELIZABETH BLACK (NPI# 1679051668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679051668 |
| Entity Type | Individual |
| Full Name | MARY ELIZABETH BLACK |
| Credential | NP-C |
| Practice Address |
222 Dave Ward Drive Conway AR 72032 |
| Practice Telephone | 5015058400 |
| Practice Fax Number | 5013278199 |
| Mailing Telephone | 5015058400 |
| Mailing Fax Number | 5013278199 |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A005463 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356813984 | Mary Ann Black | Registered Nurse | 1334 Dallas Ave, Winter Park, FL 32789-3641 | 2018-12-20 |
| 1750823456 | Mary Black | Case Manager/Care Coordinator | 1427 Oakland St, Saint Clair, MI 48079-5122 | 2016-11-11 |
| 1730353715 | Mary K Black | Occupational Therapist | 16 Jacobs Mill Ct, Elgin, SC 29045-8646 | 2008-04-21 |
| 1669532107 | Mary Ellen Black | Counselor | 102 East Gambier Street, Mount Vernon, OH 43050 | 2006-12-12 |
| 1407855034 | Mary M Black | Dietitian, Registered | 4300 Fayetteville Rd, Lumberton, NC 28358-2677 | 2005-07-15 |
| 1093289803 | Mary Ward Black | Psychologist | 320 Lester Hall, University, MS 38677 | 2019-01-15 |
| 1760997431 | Mary Black | Registered Nurse | 1058 College Dr, New Town, ND 58763-9112 | 2017-12-04 |
| 1417375510 | Mary E Black | Family Medicine | 825 E Rundberg Ln Ste B1, Austin, TX 78753-4860 | 2014-04-04 |
| 1710200233 | Mary Ann Black | Pharmacist | 200 W Belleview Ave, Englewood, CO 80110-6610 | 2010-03-11 |
| 1750573515 | Mary Frances Black | Registered Nurse | 401 E 34th St, Indianapolis, IN 46205-3754 | 2007-08-15 |
| Street Address |
222 DAVE WARD DRIVE |
| City | CONWAY |
| State | AR |
| Zip Code | 72032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
| 1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
| 1285005140 | Conway Community Services | General Acute Care Hospital | 1555 Exchange Avenue, Conway, AR 72032 | 2015-10-16 |
| Find all providers in zip 72032 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617594 | Mckenzie Lauren Cotton | Nurse Practitioner | 1065 Skyline Dr, Conway, AR 72032-3530 | 2020-10-25 |
| 1316566607 | Shannon Busby | Nurse Practitioner | 1505 Winterbrook Dr, Conway, AR 72034-3564 | 2020-04-16 |
| 1538798087 | Glenda Darlene Gore | Nurse Practitioner | 17 Kali Ct, Conway, AR 72032-9477 | 2020-04-06 |
| 1265071427 | Dana Aysha Niederhauser | Nurse Practitioner | 1250 Littlewood Cv, Conway, AR 72032-8986 | 2020-01-04 |
| 1285287680 | Joy Griffith | Nurse Practitioner | 2907 Percy Cir, Conway, AR 72034-5508 | 2019-07-24 |
| 1366094260 | Kerry Kathryn Lewis | Nurse Practitioner | 1910 Royal Dr, Conway, AR 72034-7346 | 2019-07-10 |
| 1487113148 | Laura B Kelly | Nurse Practitioner | 2300 Linda Dr, Conway, AR 72032-8999 | 2019-03-12 |
| 1780141069 | Ashleigh Lynn Kinon | Nurse Practitioner | 2065 Woodlawn Dr, Conway, SC 29526-7703 | 2019-02-22 |
| 1780191015 | Sydnie Thessing | Nurse Practitioner | 605 Dave Ward Drive #105, Conway, AR 72034 | 2018-01-09 |
| 1225568272 | Dustin Luke Van Pelt | Nurse Practitioner | 150 E Siebenmorgen Rd, Conway, AR 72032-4000 | 2017-06-13 |
| Find all providers in CONWAY | ||||
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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.