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

Nicole Clark

Individual provider Physician Assistant · NPI 1720606130

Nicole Clark is a Physician Assistant in Everett, Pennsylvania. Qualified in 2020, 6 years ago. Practices with Central Vermont Medical Center Inc, a 240-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Pennsylvania and Vermont.

Years since qualifying
6
Licensed in
PA, VT
In the registry since
2020
Specialties on file
2

Practice location Address checks out

10455 Lincoln Hwy
Everett, PA 15537-7046
Phone: (814) 623-6161
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 130 Fisher Rd Unit 1, Berlin, VT 05602-8132 — (802) 225-1743

Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X · Licence MA061686 (PA)
Physician Assistant Taxonomy 363A00000X · Licence 055-0031682 (VT)

Record details

NPI number1720606130
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 13, 2020
Last updated in NPPESJuly 18, 2023
Certification dateJuly 18, 2023
Mailing address412 Bunker Hill Rd, Everett, PA 15537-5539

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Central Vermont Medical Center Inc — 240 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Everett