Provider Demographics
NPI:1417274697
Name:CLIFTON, BETTY JANE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:JANE
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4000 KRESGE WAY
Mailing Address - Street 2:BAPTIST HOSPITAL EAST
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-896-7746
Mailing Address - Fax:502-896-7094
Practice Address - Street 1:4000 KRESGE WAY
Practice Address - Street 2:BAPTIST HOSPITAL EAST
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-896-7746
Practice Address - Fax:502-896-7094
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3005800363L00000X
KY1039892163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse