- Practice location
- 130 Fisher RD Unit 1, Berlin, VT 05602-8132
- Phone
- 802-225-1743
- Fax
- —
- Last updated
- September 9, 2026
Nicole Clark is a Physician Assistant based in Berlin, VT. Nicole Clark practices in Berlin, VT. The NPI Number for Nicole Clark is 1720606130 and holds a License No. 055-0031682 (VT). The current practice location address for Nicole Clark is 130 Fisher RD Unit 1, Berlin, VT 05602-8132 and can be reached out via phone at 802-225-1743.
Provider Profile Details
- NPI Number
- 1720606130
- Provider Name
- Nicole Clark
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 130 Fisher RD Unit 1, Berlin, VT 05602-8132
- Phone Number
- 802-225-1743
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- July 13, 2020
- Last Update Date
- September 9, 2026
- Certification Date
- September 9, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 130 Fisher RD Unit 1
Berlin, VT 05602-8132 - City
- Berlin
- State
- Vermont
- Zip
- 05602-8132
- Phone Number
- 802-225-1743
Provider Business Mailing Address Details
- Address
- 412 Bunker Hill RD
Everett, PA 15537-5539 - City
- Everett
- State
- PA
- Zip
- 15537-5539
License Information
- License Number
- 055-0031682
- License State
- VT
- Taxonomy
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Nicole Clark?
The NPI number of Nicole Clark is 1720606130. It was assigned on July 13, 2020 and is currently active in the NPPES registry.
What is the specialty of Nicole Clark?
Nicole Clark is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in VT under license number 055-0031682.
Where does Nicole Clark practice?
The practice location is 130 Fisher RD Unit 1, Berlin, VT 05602-8132. The office can be reached at 802-225-1743 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1720606130 directly on the NPPES registry website.