DEBORAH A CLARK RN CS NP NPI 1396729331

NPI Information

  • NPI: 1396729331
  • Provider Name: DEBORAH A CLARK, RN, CS, NP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 3 ESSEX GREEN DR
    PEABODY, MA
    ZIP 01960
  • Phone: (781) 307-6094

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NPI Details

Deborah A Clark, RN, CS, NP is a psychiatric/mental health nurse practitioner in Peabody, MA. Deborah A Clark, RN, CS, NP NPI is 1396729331. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3 ESSEX GREEN DR
PEABODY, MA
ZIP 01960-913
Phone: (781) 307-6094
Fax: (781) 334-4196

The enumeration date for this NPI number is 12/2/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health153934MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1NS0377MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
2PO6221MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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