Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Eddie Kevin Mark, APRN

Individual provider Pediatric Nurse Practitioner · NPI 1922417807

Eddie Kevin Mark, APRN is a Nurse Practitioner in Worcester, Massachusetts. Qualified in 2014, 12 years ago. Practices with Seattle Childrens Hospital, a 111-clinician group and accepts Medicare assignment. Licensed in Connecticut and Massachusetts.

Years since qualifying
12
Licensed in
CT, MA
In the registry since
2014
Specialties on file
3
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

55 Lake Ave N
Worcester, MA 01655-0002
Phone: (774) 442-2853
Fax: (774) 443-7042
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN2297770 (MA)
Pediatric Nurse Practitioner Taxonomy 363LP0200X · Licence 5790 (CT)
Pediatric Nurse Practitioner Taxonomy 363LP0200X · Licence RN2297770 (MA)

Record details

NPI number1922417807
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN
Sole proprietorNo
NPI enumeratedAugust 5, 2014
Last updated in NPPESFebruary 11, 2015
Mailing addressPo Box 415348, Boston, MA 02241-5348

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Seattle Childrens Hospital — 111 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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