Provider Demographics
NPI:1942565304
Name:TULLOCK, CLARE M (F NP)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:M
Last Name:TULLOCK
Suffix:
Gender:F
Credentials:F NP
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Mailing Address - Street 1:780 MAIN ST
Mailing Address - Street 2:STE 1
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-2149
Mailing Address - Country:US
Mailing Address - Phone:413-528-2418
Mailing Address - Fax:413-528-2907
Practice Address - Street 1:820 STATE RD
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-3027
Practice Address - Country:US
Practice Address - Phone:413-664-4088
Practice Address - Fax:413-663-6405
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2017-09-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN264971363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily