Provider Demographics
NPI:1598309536
Name:CLIFFORD, STEPHANIE ANN (CNP, RN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:CLIFFORD
Suffix:
Gender:F
Credentials:CNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237A STATE RD
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-2612
Mailing Address - Country:US
Mailing Address - Phone:508-991-9188
Mailing Address - Fax:508-471-3138
Practice Address - Street 1:237A STATE RD
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-2612
Practice Address - Country:US
Practice Address - Phone:508-991-9188
Practice Address - Fax:508-418-7223
Is Sole Proprietor?:No
Enumeration Date:2019-11-02
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2261227163W00000X, 363LF0000X
RIAPRN02288363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse