Individual
KRISTEN NANCY FEIFERT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN CNM
Contact information
Practice address
22 WEST ST STE 25, MILLBURY, MA 01527-2622
(508) 917-6720
(508) 917-6721
Mailing address
22 WEST ST STE 25, MILLBURY, MA 01527-2622
(508) 917-6720
(508) 917-6721
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN242199
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110099291A
MEDICAID PTAN
MA
01
—
S100140020
MEDICARE PTAN
MA
Enumeration date
11/05/2013
Last updated
10/06/2016
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