NPI 1508185760

Levi Colter Black, CRNA

Practitioner Certified Registered Nurse Anesthetist Roswell, NM

Practice location

Address: 117 E 19th St, Roswell, NM 88201-5151
Phone: (814) 877-2137
Mailing address: 530b Harkle Rd STE 100, Santa Fe, NM 87505-4739

Registered specialties

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence CRNA0680 (AZ)

Other Nurse Anesthetist, Certified Registered providers in New Mexico →

Registry record

NPI: 1508185760
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 May 2010
Record last updated: 5 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.