Individual
TRACY NICOLE CLIFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
130 S 63RD ST, MESA, AZ 85206-1620
(480) 981-2888
Mailing address
130 S 63RD ST STE 114, MESA, AZ 85206-1620
(480) 981-2888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AP11743
AZ
Other
Enumeration date
11/01/2018
Last updated
11/13/2019
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