| Doctor Name: | NICOLE ANNETTE CLARKE |
| NPI Number: | 1033507868 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 2284312 |
| Business Practice Address: | 426 East St Pittsfield, MA - 012015308 |
| Business Phone Number: | 9788211723 |
| Business Fax Number: | |
| Mailing Address: | 9 Summer St Unit 2, BEVERLY |
| State: | MA |
| Postal Code: | 019153317 |
| Phone Number: | 9788211723 |
| Fax Number: | |
| NPI Enumeration Date: | 01/01/2015 |
| NPI Last Update Date: | 01/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 2284312 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |