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Contact Information

MAUREEN BLACK, RN
5121 S COTTONWOOD ST
IM WOMEN AND CHILDREN ADMINISTRATION 15400-15541
MURRAY, UT84107-5701
 Phone: 801-507-7673
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Women

282NW0100X
Indicates primary specialty

NPI Profile & details for MAUREEN BLACK · (Female)

NPI # 1528431335
Status Active
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 11/03/2015
Last updated 11/03/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 290597-3102
  • UT Medicaid 942854057
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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