IndividualActive
Jackie Black, RN
NPI 1629144308 · Community Health Registered Nurse · Provo, UT
Jackie Black, RN is a Community Health Registered Nurse provider in Provo, UT (NPI 1629144308).
Provider details
- NPI number
- 1629144308
- Entity type
- Individual
- Primary specialty
- Community Health Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- License
- 218040-3102 (UT)
Specialties & taxonomies
Nursing Service Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
151 S University Ave # 1900
Provo, UT 84601-4427
Phone: (801) 851-7026
Fax: (801) 343-8725
Street-level locationGet directions
Mailing address
265 E 200 S
Salem, UT 84653-9452
Registry dates
- Enumerated
- 2006-11-27
- Last updated
- 2007-07-09
Frequently asked questions
- What is Jackie Black's NPI number?
- Jackie Black's National Provider Identifier (NPI) is 1629144308, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jackie Black's specialty?
- Jackie Black is listed in the NPPES registry with a primary specialty of Community Health Registered Nurse (Nursing Service Providers).
- Where is Jackie Black located?
- Jackie Black's practice location on file with NPPES is 151 S University Ave # 1900, Provo, UT 84601-4427.
- What is Jackie Black's phone number?
- The practice phone number listed in the NPPES registry for Jackie Black is (801) 851-7026.
- Is Jackie Black's NPI active?
- Yes — Jackie Black's NPI (1629144308) is active in the NPPES registry as of the last update on 2007-07-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.