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Individual
MISS THERESA LYNN CLIFFORD
Active
Individual
MISS THERESA LYNN CLIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P., A.P.R.N.
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3002154
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000626807
ANTHEM
KY
01
—
3722988000
PASSPORT ADVANTAGE
KY
01
—
50024463
PASSPORT
KY
05
—
7100078250
—
KY
Enumeration date
10/19/2006
Last updated
04/18/2018
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