Individual provider · Type 1 NPI

Dylan Ross Clark, STUDENT

Certified Registered Nurse Anesthetist · Boston, MA

NPI number 1104530930 Active

Practice location

1 Boston Medical Center Place
Boston, MA 02118

Mailing address

960 Massachusetts Ave, Flr 2
Boston, MA 02118

Other practice locations

  • 140 Commonwealth Ave, Chestnut Hill, MA 02467-3858 · (617) 552-2756

Specialties and licenses

TaxonomyCodeLicense
Certified Registered Nurse Anesthetist Primary 367500000XRN2287470 (MA)
Registered Nurse 163W00000XRN2287470 (MA)

Certified Registered Nurse Anesthetist: (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of creden…

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About NPI 1104530930

Dylan Ross Clark, STUDENT's National Provider Identifier is 1104530930, issued on Jan 6, 2023. The primary taxonomy on file is Certified Registered Nurse Anesthetist (367500000X), and the practice location is in Boston, MA. The record was last updated on Apr 2, 2026.