Nicole Black, PA-C

NPI #1043874910 in Marietta, Georgia

Provider Information

NPI Number: 1043874910
Entity Type: Individual
Name: Nicole Black, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Apr 26, 2019
Last Updated: Aug 8, 2024

Practice Location

Address: 111 MARBLE MILL RD NW
City: Marietta
State: Georgia
ZIP Code: 30060-1047
Phone: (770) 422-1013

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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