Individual
ELIZABETH N CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
874 PURCHASE ST, NEW BEDFORD, MA 02740-6232
(508) 992-6553
(508) 990-7558
Mailing address
874 PURCHASE ST, NEW BEDFORD, MA 02740-6232
(508) 992-6553
(508) 990-7558
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
204438
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0037494
NEIGHBORHOOD HEALTH
MA
05
—
0703729
—
MA
01
—
09774-3
BCBSRI
MA
01
—
412832
BCBSRI BLUE CHIP
MA
01
—
87495
CHILDRENS MEDICAL SECURIT
MA
01
—
NP5006
BCBSMA
MA
Enumeration date
06/15/2006
Last updated
06/07/2011
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