Provider Demographics
NPI:1164903035
Name:CLIFTON, DANIE MARIE (LVN)
Entity Type:Individual
Prefix:
First Name:DANIE
Middle Name:MARIE
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 RAWHIDE RD
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-1490
Mailing Address - Country:US
Mailing Address - Phone:830-556-4481
Mailing Address - Fax:
Practice Address - Street 1:1265 RAWHIDE RD
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155
Practice Address - Country:US
Practice Address - Phone:830-556-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX327733164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse