Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

MS. Christan Shadeene Black, AGNP-BC

Individual provider Gerontology Nurse Practitioner · NPI 1285368423

MS. Christan Shadeene Black, AGNP-BC is a Nurse Practitioner in Winston Salem, North Carolina. Qualified in 2021, 5 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in North Carolina.

Years since qualifying
5
Licensed in
NC
In the registry since
2022
Specialties on file
2

Practice location Address checks out

2001 Todays Woman Ave
Winston Salem, NC 27105-5069
Phone: (336) 722-1818
Fax: (336) 722-1826
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 650 East Brooklyn Avenue, Charlotte, NC 28202 — (540) 676-0685

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 5018146 (NC)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 2021103998 (NC)

Record details

NPI number1285368423
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-BC
Sole proprietorYes
NPI enumeratedJuly 13, 2022
Last updated in NPPESJune 25, 2024
Certification dateJune 25, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Winston Salem