# MIRIAM CLARK

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609313428
- **Authorized official:** MRS. MIRIAM CLARK FNP, RN (FAMILY NURSE PRACTITIONER)
- **Authorized official phone:** (781) 235-3182

## Contact information

- **Practice address:** 35 CHESTERTON RD, WELLESLEY, MA 02481-1106
- **Practice address phone:** (781) 235-3182
- **Mailing address:** 35 CHESTERTON RD, WELLESLEY, MA 02481-1106
- **Mailing address phone:** (781) 235-3182

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | RN2284844 | MA | Yes |

## Other

- **Enumeration date:** 01/31/2017
- **Last updated:** 01/31/2017