Provider Demographics
NPI:1891167979
Name:CLIFTON, ERNIE RAY II (CNP)
Entity Type:Individual
Prefix:MR
First Name:ERNIE
Middle Name:RAY
Last Name:CLIFTON
Suffix:II
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 BUCYRUS RD
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-1509
Mailing Address - Country:US
Mailing Address - Phone:419-468-4220
Mailing Address - Fax:
Practice Address - Street 1:955 BUCYRUS RD
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-1509
Practice Address - Country:US
Practice Address - Phone:419-468-4220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-353484-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily