Clark, Nisse Virginia

Clark, Nisse Virginia is an individual health care provider with primary practice located at 55 Fruit St , Boston MA 02114-2621. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Gynecology is her primary health care specialty. Clark, Nisse Virginia can be contacted via phone (617) 724-6850.

Contact Information

Primary practice address
55 Fruit St Boston MA 02114-2621
Phone: (617) 724-6850
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 252130 Massachusetts
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 265956 Massachusetts

Profile Details

NPI number 1982967105
LBN Legal business name Clark, Nisse Virginia
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2012
Last updated Apr 11th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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