Provider Demographics
NPI:1417179706
Name:CLIFTON, JENNIFER MARIE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARIE
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3613 SUNRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-4660
Mailing Address - Country:US
Mailing Address - Phone:435-615-6569
Mailing Address - Fax:801-261-2167
Practice Address - Street 1:3450 S 900 W
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-4104
Practice Address - Country:US
Practice Address - Phone:801-261-2060
Practice Address - Fax:801-261-2617
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTAPRN 3200004405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily