Provider Demographics
NPI:1417621301
Name:CLIFTON, MELONY (RN/NCM)
Entity Type:Individual
Prefix:
First Name:MELONY
Middle Name:
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:RN/NCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 BEDROCK DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5773
Mailing Address - Country:US
Mailing Address - Phone:254-287-9222
Mailing Address - Fax:
Practice Address - Street 1:CARL R. DARNALL ARMY MEDICAL CENTER
Practice Address - Street 2:36065 SANTA FE AVENUE
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-287-9222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX786379163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management