| Doctor Name: | MRS. CANDICE A CLARK |
| NPI Number: | 1700297421 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN212758 |
| Business Practice Address: | 152 S Washington St Belchertown, MA - 010079604 |
| Business Phone Number: | 4135303647 |
| Business Fax Number: | |
| Mailing Address: | 152 S Washington St, BELCHERTOWN |
| State: | MA |
| Postal Code: | 010079604 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/15/2014 |
| NPI Last Update Date: | 05/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | RN212758 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |