| Casey R Black, NP | |
|
125 Eagle Spring Dr, Stockbridge, GA 30281-6328 | |
| (770) 213-3366 | |
| (404) 962-6943 |
| Full Name | Casey R Black |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 125 Eagle Spring Dr, Stockbridge, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003151028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | RN146749 (Georgia) | Primary |
| Entity Name | Magnolia Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801340856 PECOS PAC ID: 5799066387 Enrollment ID: O20161219001375 |
| Mailing Address | Practice Location Address |
|---|---|
| Casey R Black, NP 125 Eagle Spring Dr, Stockbridge, GA 30281-6328 Ph: (770) 213-3366 | Casey R Black, NP 125 Eagle Spring Dr, Stockbridge, GA 30281-6328 Ph: (770) 213-3366 |
Ms. Rita Raynel Givens, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 830 Eagles Landing Pkwy Ste 204, Stockbridge, GA 30281 Phone: 770-962-3642 Fax: 770-962-3643 | |
Ms. Eleasha R Gray, C-FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 165 North Park Trail, Stockbridge, GA 30281 Phone: 770-506-1800 Fax: 770-389-5947 | |
Jeanine Clark, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 175 Medical Blvd, Stockbridge, GA 30281 Phone: 239-443-8018 | |
Sandra Thomas, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 950 Eagles Landing Pkwy # 210, Stockbridge, GA 30281 Phone: 770-668-3363 | |
Tricia Jarrell Morris, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 547 Winter View Way, Stockbridge, GA 30281 Phone: 678-272-0086 Fax: 678-489-6860 | |
Shanea R Mcdaniel, RN, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 552 Creek Valley Ct, Stockbridge, GA 30281 Phone: 803-617-9953 |