| Doctor Name: | MRS. AMY L BLACK |
| NPI Number: | 1033424148 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | NP-11608 |
| Business Practice Address: | 1383 W Hunter St Logan, OH - 431381013 |
| Business Phone Number: | 7403852555 |
| Business Fax Number: | 7403803750 |
| Mailing Address: | 1049 Western Ave, CHILLICOTHE |
| State: | OH |
| Postal Code: | 456011104 |
| Phone Number: | 7407734366 |
| Fax Number: | 7407757855 |
| NPI Enumeration Date: | 08/12/2010 |
| NPI Last Update Date: | 10/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | NP-11608 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |