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Eddie Kevin Mark, APRN
Pediatric Nurse Practitioner in Worcester, Massachusetts
NPI 1922417807

Eddie Kevin Mark is a Pediatric Nurse Practitioner based in Boston, MA and is specialized in Pediatrics. Eddie Kevin Mark practices in Worcester, MA and has the professional credentials of APRN. The NPI Number for Eddie Kevin Mark is 1922417807 and holds a License No. 5790 (Massachusetts).

The current practice location address for Eddie Kevin Mark is 55 Lake Ave N, Worcester, MA and can be reached out via phone at 774-442-2853 and via fax at 774-443-7042.

Location: 55 Lake Ave N, Worcester, MA, 02241-5348
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922417807
Provider Name
Eddie Kevin Mark
Credential
APRN
Provider Entity Type
Individual
Gender
Male
Address
55 Lake Ave N, Worcester, MA, 02241-5348
Phone Number
774-442-2853
Fax Number
774-443-7042
Provider Enumeration Date
08/05/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
55 Lake Ave N
City
Worcester
State
Massachusetts
Zip
01655-0002
Phone Number
774-442-2853
Fax Number
774-443-7042
person
Provider Business Mailing Address Details
Address
55 Lake Ave N
City
Worcester
State
Massachusetts
Zip
01655-0002
Phone Number
774-442-2853
Fax Number
774-443-7042
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
RN2297770 (Massachusetts)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
363LP0200X
License No.
5790 (Connecticut)
Definition
Definition to come...
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