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1952727414
KELLY CLARK
BOSTON, MA
NPI
1952727414
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: MA RN167845)
Enumeration Date
2014-03-07
Last Update Date
2014-03-07
Business Address
-- KELLY CLARK
55 FRUIT ST
BOSTON, MA 02114-2621
Phone number: 617-726-2000
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Mailing Address
-- KELLY CLARK
33 ANDERSON ST APT 2
BOSTON, MA 02114-3621
Phone number: 857-445-1462
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