Jackie Evans Black, RN is a community health registered nurse in Provo, UT. Jackie Evans Black, RN NPI is 1629144308. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
The provider's business location address is:
151 S UNIVERSITY AVE # 1900
PROVO, UT
ZIP 84601-427
Phone: (801) 851-7026
Fax: (801) 343-8725
The enumeration date for this NPI number is 11/27/2006 and was last updated on 7/9/2007.