Gwendolyn Black, LPN Valid NPI

Individual provider · Licensed Practical Nurse · Mill Creek, WA

NPI

1194593970

Type

Individual (Type 1)

Primary specialty

Licensed Practical Nurse

Specialty group

Nursing Service Providers

Taxonomy code

164W00000X

License number

LP00045623 (WA)

Sex

Female

Sole proprietor

Yes

Enumerated

2023-12-12

Last updated

2023-12-12