IndividualActive
Jonathan Clark, CRNA
NPI 1275923781 · Certified Registered Nurse Anesthetist · Providence, RI
Provider details
- NPI number
- 1275923781
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- No
- License
- RN277232 (MA)
Mailing address
333 Ricciuti Dr
Quincy, MA 02169-6287
Registry dates
- Enumerated
- 2015-02-04
- Last updated
- 2021-09-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.