Provider Demographics
NPI:1356678106
Name:MEFFORD, CLEA K (RN MSN CRNP)
Entity Type:Individual
Prefix:
First Name:CLEA
Middle Name:K
Last Name:MEFFORD
Suffix:
Gender:F
Credentials:RN MSN CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1408 POMERELLE AVE # H
Mailing Address - Street 2:
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318-2064
Mailing Address - Country:US
Mailing Address - Phone:208-878-4970
Mailing Address - Fax:208-878-4974
Practice Address - Street 1:1408 POMERELLE AVE # H
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-2064
Practice Address - Country:US
Practice Address - Phone:208-878-4970
Practice Address - Fax:208-878-4974
Is Sole Proprietor?:No
Enumeration Date:2009-11-13
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDNP-895A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health