Individual provider · Type 1 NPI
Leslie Corcoran Clark, NP
Adult Health Nurse Practitioner · Boston, MA
NPI number
1700938982
Active
Practice location
55 Fruit St, Ellison 11
Boston, MA 02114-2621
Fax (617) 724-5150
Mailing address
55 Fruit Street Mgh, Ellison 11
Boston, MA 02114
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | 154837 (MA) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1700938982
Leslie Corcoran Clark, NP's National Provider Identifier is 1700938982, issued on Jan 17, 2007. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Boston, MA. The record was last updated on Jul 8, 2007.