Kelly Black is a Mesa, Arizona based nurse practitioner. Active license number of Kelly Black is 95024873 for Psych/Mental Health in California. Her current practice location is 1910 S Stapley Dr Ste 120, Mesa. Patients can reach her at 602-341-3303. Kelly Black is PMHNP-BC and her NPI number (Unique professional ID assigned by NPPES) is 1912653536. Kelly Black has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Kelly Black speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
Name:
Kelly Black
Specialization:
Nurse Practitioner (NP)
Gender:
Female
Credentials:
PMHNP-BC
Practice Address:
1910 S Stapley Dr Ste 120, Mesa, Arizona, 85204-6676
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1912653536
NPI Enumeration Date:
22 Feb, 2022
NPI Last Update On:
06 Feb, 2025
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kelly Black are as mentioned below.
License Number
Specialization
State
Status
95024873
Psych/Mental Health
California
Primary
56220
Registered Nurse
California
Secondary
305924
Psych/Mental Health
Arizona
Secondary
Other Medical Identifiers:
Other legacy medical identifiers associated with Kelly Black such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
305924
Other
Arizona
ARIZONA BOARD OF NURSING CERTIFIED NURSE PRACTITIONER LICENSE PMHNP-BC
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Kelly Black 1910 S Stapley Dr Ste 120, Mesa, Arizona
Zip:
85204-6676
Phone Number:
951-623-7194
Patients can reach Kelly Black at 1910 S Stapley Dr Ste 120, Mesa, Arizona or can call to book an appointment on 602-341-3303.
Comments/ Reviews:
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 June, 2025.