IVY BLACK, C-NP

Nurse Practitioner - Family

Active Individual
NPI: 1104571462

Practice Address

2782 COBB PKWY NW
Kennesaw, GA 30152

Phone: (706) 405-1195

Specialties

Specialty Code Primary License
Nurse Practitioner - Family 363LF0000X Yes RN195496 (GA)

Frequently Asked Questions

NPI 1104571462 is the National Provider Identifier for IVY BLACK, C-NP, a Nurse Practitioner - Family provider located in Kennesaw, GA. This NPI was enumerated on February 15, 2022.
IVY BLACK, C-NP practices at 2782 COBB PKWY NW, Kennesaw, GA 30152.

Quick Facts

NPI
1104571462
Type
Individual
Enumerated
Feb 15, 2022
Last Updated
Jun 12, 2025

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