Provider Demographics
NPI:1588207773
Name:DUCLOS, MARCIA MARGARITA (DNP)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:MARGARITA
Last Name:DUCLOS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:19 BONNER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013-1127
Mailing Address - Country:US
Mailing Address - Phone:413-426-2367
Mailing Address - Fax:
Practice Address - Street 1:48 SANDERSON ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2778
Practice Address - Country:US
Practice Address - Phone:413-773-2022
Practice Address - Fax:413-773-4945
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2289603163WR0400X
MARN2289603363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation