JACKIE EVANS BLACK (RN) – Community Health Registered Nurse, NPI 1629144308

JACKIE EVANS BLACK (RN) is a healthcare provider. based in Provo, Utah. specializing in Community Health Registered Nurse. They hold the professional credentials RN. They hold a License No. 218040-3102 (UT). The NPI Number for JACKIE EVANS BLACK (RN) is 1629144308

Main info

Female
Name
JACKIE EVANS BLACK (RN)
NPI
1629144308
Phone
(801) 851-7026
Address
151 S UNIVERSITY AVE # 1900
Enumeration Date
27 November 2006
Last Update Date
9 July 2007
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for JACKIE EVANS BLACK (RN)

  • South University Avenue, East Bay, Provo, Utah County, Utah, 84606, United States

    PROVO, UT 846014427

    Phone: (801) 851-7026

    Fax: (801) 343-8725

    Type: Location

  • 265, E 200 S, Salem, Black Creek Township, Adams County, Indiana, 46772, United States

    SALEM, UT 846539452

    Phone: (801) 423-2373

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84601)

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Reviews

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Frequently asked questions

Can I cross-check JACKIE EVANS BLACK (RN) using NPI 1629144308?
NPI 1629144308 belongs to JACKIE EVANS BLACK (RN); compare other details if you need extra assurance.
Would JACKIE EVANS BLACK (RN) appear as active to a payer?
You can treat JACKIE EVANS BLACK (RN) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe JACKIE EVANS BLACK (RN)'s focus?
For JACKIE EVANS BLACK (RN), the primary taxonomy reads as Community Health Registered Nurse. Clinical services aligned with this taxonomy classification.
Where in Utah is JACKIE EVANS BLACK (RN) registered?
Use Provo, Utah as the headline location for JACKIE EVANS BLACK (RN) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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