Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN2283423 | MA |
NPI | 1003282542 |
---|---|
Provider Name | Rachel Clay |
First Address | New Bedford, MA 02740-2208 |
Second Address | New Bedford, MA 02740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2015 |
Last Update Date | 15/01/2016 |