Individual
KAELEN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
386 WASHINGTON ST STE 2, WELLESLEY, MA 02481-6218
(617) 326-3232
Mailing address
23 BRIDGE ST APT 206, QUINCY, MA 02169-2021
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2358296
MA
363L00000X
Nurse Practitioner
Primary
RN2358296
MA
Other
Enumeration date
05/18/2023
Last updated
06/09/2024
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