Thomas Black, NP
NPI #1619346376 in Edgewood, New Mexico
Provider Information
- NPI Number
- 1619346376
- Entity Type
- Individual
- Name
- Thomas Black, NP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Family
- Credential
- NP
- Enumeration Date
- Sep 23, 2015
- Last Updated
- Jul 26, 2021
Practice Location
- Address
- 104 QUAIL TRAIL
- Address 2
- UNIT B
- City
- Edgewood
- State
- New Mexico
- ZIP Code
- 87015
- Phone
- (505) 208-0208
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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