Provider Demographics
NPI:1114251154
Name:CLIFFORD, LAVONNE MAY (FNP-C)
Entity Type:Individual
Prefix:
First Name:LAVONNE
Middle Name:MAY
Last Name:CLIFFORD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 B HWY 76
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188
Mailing Address - Country:US
Mailing Address - Phone:615-306-9996
Mailing Address - Fax:615-334-6157
Practice Address - Street 1:614 B HWY 76
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188
Practice Address - Country:US
Practice Address - Phone:615-306-9996
Practice Address - Fax:615-334-6157
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN151560163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care