LAURIE JO BLACK (NPI# 1679551329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679551329 |
| Entity Type | Individual |
| Full Name | LAURIE JO BLACK |
| Other Name | LAURIE JO PEREIRA |
| Credential | RN CNP |
| Practice Address |
1200 6th Ave N Centra Care Clinic Saint Cloud MN 56303-2735 |
| Practice Telephone | 3202512700 |
| Practice Fax Number | 7275877739 |
| Mailing Telephone | 3202512700 |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2014-11-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
R217274-5 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
ARNP2638602 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 0307418800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174829881 | Laurie Lee Black | Social Worker | 591 Kimberly Ct, Farmington, MO 63640-2032 | 2011-01-28 |
| 1376109736 | Laurie Ann Black | Registered Nurse | 1655 N Gladstone Ave Ste A, Columbus, IN 47201-5380 | 2019-05-11 |
| 1508393968 | Laurie Ann Black | Psychologist | Evans Army Community Hospital, 1650 Cochrane Cir B7500, Colorado Springs, CO 80913 | 2017-05-16 |
| 1144593112 | Laurie Carol Black | Counselor | 1255 Pearl St, Eugene, OR 97401-3570 | 2012-02-21 |
| Street Address |
1200 6TH AVE N CENTRA CARE CLINIC |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-2735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902805518 | Paul Charles Peterson | Emergency Medicine | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2005-07-15 |
| 1871127290 | Kayla Girgen | Dietitian, Registered | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2020-02-25 |
| 1023640034 | Faith Kelly Dammann | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2736 | 2020-02-07 |
| 1538707377 | Alissa Wigen | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2019-12-11 |
| 1639713290 | Jordan Lajoie | Nurse Practitioner | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2019-11-06 |
| 1528602430 | Hannah Elise Osterndorf | Dietitian, Registered | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2019-11-04 |
| 1558919100 | Mergitu Megersa Gemeda | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2736 | 2019-08-27 |
| 1659927879 | Jennifer Marie Bretscher | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2019-08-13 |
| 1366094302 | Laura Verley | Registered Nurse | 1200 6th Ave N, Saint Cloud, MN 56303-2736 | 2019-07-10 |
| 1063074235 | Briana Gray | Pharmacist | 1200 6th Ave N, Internal Medicine, Saint Cloud, MN 56303-2735 | 2019-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154931475 | Megan Ann Brown | Nurse Practitioner | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-08-01 |
| 1487857249 | Pam J. Waage | Nurse Practitioner | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2007-06-08 |
| 1992742357 | Cynthia Jean Betzler | Nurse Practitioner | 1900 Centracare Cir, Centracare Clinic Womens & Childrens, Saint Cloud, MN 56303-5000 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518587120 | Amanda Joy Dominik | Nurse Practitioner | 4411 Arden View Ct, Arden Hills, MN 55112-1944 | 2020-04-23 |
| 1881245504 | Hailey Prescott | Nurse Practitioner | 2450 Riverside Avenue Se, Minneapolis, Mn, MN 55454-1400 | 2019-09-24 |
| 1598317570 | Elisabeth Palmquist | Nurse Practitioner | 12000 Elm Creek Blvd N Ste 250, Maple Grove, MN 55369-7164 | 2019-07-10 |
| 1538644562 | Angela Ashton | Nurse Practitioner | 345 Smith Ave N Ste 404, Saint Paul, MN 55102-2346 | 2018-09-25 |
| 1558865295 | Meghan Kerry Deyo | Nurse Practitioner | 1804 7th St W Ste 200, Saint Paul, MN 55116-2300 | 2018-03-19 |
| 1336642131 | Caitlin Anna Lingbeck | Nurse Practitioner | 14001 Ridgedale Dr #100, Minnetonka, MN 55305-1781 | 2018-03-18 |
| 1740799246 | Maya Bastian | Nurse Practitioner | 12220 Travois Rd, Eden Prairie, MN 55347-4241 | 2017-09-27 |
| 1821523028 | Robin Marie Parker | Nurse Practitioner | 14135 Cedar Avenue South, Suite 100, Apple Valley, MN 55124 | 2017-04-25 |
| 1538691043 | Jenifer Flegel | Nurse Practitioner | 963 Robert St S, West Saint Paul, MN 55118-1446 | 2017-04-03 |
| 1154796811 | Megan Stark | Nurse Practitioner | 2805 Campus Dr Ste 235, Plymouth, MN 55441-2678 | 2015-12-07 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
Please comment or provide details below to improve the information on LAURIE JO BLACK.
| 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.