| Carol Lynn Black, APRN-CNP | |
|
107 E Post Ave, Coalgate, OK 74538-3004 | |
| (580) 927-2828 | |
| (580) 927-9876 |
| Full Name | Carol Lynn Black |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 9 Years |
| Location | 107 E Post Ave, Coalgate, Oklahoma |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013427129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 67047 (Oklahoma) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | R0067047 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mays Housecall Home Health Of Durant | Durant, OK | Home health agency |
| Always Better Care Home Health | Durant, OK | Home health agency |
| Tendercare Home Health | Coalgate, OK | Home health agency |
| Mary Hurley Hospital | Coalgate, OK | Hospital |
| Mercy Hospital Ada | Ada, OK | Hospital |
| Mercy Hospital Ardmore, Inc | Ardmore, OK | Hospital |
| Alliancehealth Durant | Durant, OK | Hospital |
| O U Medical Center | Oklahoma city, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Family Health Center Of Southern Oklahoma Inc | 4284537457 | 32 |
| Entity Name | Family Health Center Of Southern Oklahoma Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598803942 PECOS PAC ID: 4284537457 Enrollment ID: O20040127001108 |
| Mailing Address | Practice Location Address |
|---|---|
| Carol Lynn Black, APRN-CNP 610 E 24th St, Tishomingo, OK 73460-3245 Ph: (580) 371-2343 | Carol Lynn Black, APRN-CNP 107 E Post Ave, Coalgate, OK 74538-3004 Ph: (580) 927-2828 |