Provider Demographics
NPI:1073690020
Name:CLIZBE, DENISE PALMER (RN, CCRC)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:PALMER
Last Name:CLIZBE
Suffix:
Gender:F
Credentials:RN, CCRC
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:CAROL
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CCRC
Mailing Address - Street 1:10802 RIDGE POINT PL
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6660
Mailing Address - Country:US
Mailing Address - Phone:301-514-0079
Mailing Address - Fax:
Practice Address - Street 1:1425 PORTER ST
Practice Address - Street 2:DIVISION OF MEDICINE, USAMRIID
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9211
Practice Address - Country:US
Practice Address - Phone:301-619-6869
Practice Address - Fax:301-619-2312
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR1140941744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study