Molly Black, - Nurse Anesthetist, Certified Registered in Fort Polk, LA

Molly Black, is a Nurse Anesthetist, Certified Registered based in Fort Polk, Louisiana. Molly Black is licensed to practice in Texas (license number 971137) and her current practice location is 1585 3rd St, Fort Polk, Louisiana. She can be reached at her office (for appointments etc.) via phone at (210) 862-9692.

NPI number for Molly Black is 1114529674 and her current mailing address is 43 Bassett St, Fort Bragg, North Carolina. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1114529674.

Contact Information

Molly Black,
1585 3rd St,
Fort Polk, LA 71459-5102
(210) 862-9692
Not Available



Provider's Profile

Full NameMolly Black
GenderFemale
SpecialityNurse Anesthetist, Certified Registered
Location1585 3rd St, Fort Polk, Louisiana
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1114529674
  • Provider Enumeration Date: 11/10/2020
  • Last Update Date: 07/07/2022

Medical Identifiers

Medical identifiers for Molly Black such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114529674NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 971137 (Texas)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Molly Black is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Molly Black,
43 Bassett St,
Fort Bragg, NC 28307-2032

Ph: () -
Molly Black,
1585 3rd St,
Fort Polk, LA 71459-5102

Ph: (210) 862-9692

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Nurse Anesthetist, Certified Registered Nurses in Fort Polk, LA

Anthony Wendell Marcukaitis, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1585 Third St, Fort Polk, LA 71459
Phone: 337-531-3517    
Mr. Douglas Anthony Phillips, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 1585 3rd St, Bayne Jones Army Community Hospital, Fort Polk, LA 71459
Phone: 337-531-3344    
Douglas Tortella, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1585 3rd St, Fort Polk, LA 71459
Phone: 337-531-3011    
Mr. Raymond James Devlin Iii, MSN, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 16513 Howard St, Apt D, Fort Polk, LA 71459
Phone: 337-537-5375    
Marshall Glenister, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 1585 3rd St, Fort Polk, LA 71459
Phone: 254-760-9499    
Travis Husser, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 1585 3rd St, Fort Polk, LA 71459
Phone: 985-981-6455    

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