Individual
DEIRDRE M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5 FOUNDERS ST STE 102, WILLIMANTIC, CT 06226-2050
(860) 456-2898
Mailing address
326 WASHINGTON ST, NORWICH, CT 06360-2740
(860) 889-8331
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
7460
CT
363LA2200X
Adult Health Nurse Practitioner
NPP37710
RI
363LG0600X
Gerontology Nurse Practitioner
NPP37710
RI
Other
Enumeration date
06/26/2012
Last updated
04/25/2023
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