Provider Demographics
NPI:1467830687
Name:BLACK, SHELIA MARIA (DNP, NP-C)
Entity type:Individual
Prefix:DR
First Name:SHELIA
Middle Name:MARIA
Last Name:BLACK
Suffix:
Gender:F
Credentials:DNP, NP-C
Other - Prefix:
Other - First Name:SHELIA
Other - Middle Name:MARIA
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3017 DALMATION DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-4008
Mailing Address - Country:US
Mailing Address - Phone:910-273-1295
Mailing Address - Fax:
Practice Address - Street 1:1601 OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3425
Practice Address - Country:US
Practice Address - Phone:910-678-0100
Practice Address - Fax:910-678-0110
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007628363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner