Provider Demographics
NPI:1538352885
Name:BLACK, NATALIA TANISHA (MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:NATALIA
Middle Name:TANISHA
Last Name:BLACK
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Gender:F
Credentials:MSN, FNP-C
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Mailing Address - Street 1:5508 PARKCREST DR STE 310
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4915
Mailing Address - Country:US
Mailing Address - Phone:512-420-9900
Mailing Address - Fax:512-420-9944
Practice Address - Street 1:5508 PARKCREST DR STE 310
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4915
Practice Address - Country:US
Practice Address - Phone:512-420-9900
Practice Address - Fax:512-420-9944
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2021-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP129404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily