Individual
COURTNEY ELIZABETH CLIFTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
910 E HOUSTON ST, TYLER, TX 75702-8369
(903) 606-7995
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP137829
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
392553901
—
TX
01
—
749870
MEDICARE
TX
01
—
P02158853
MEDICARE RAIL ROAD
TX
Enumeration date
10/26/2018
Last updated
03/04/2019
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