Provider Demographics
NPI:1902027386
Name:CLIFTON, TRUETT BARRON (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:TRUETT
Middle Name:BARRON
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:TRUDY
Other - Middle Name:BARRON
Other - Last Name:CLIFTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:WHNP
Mailing Address - Street 1:205 E UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6821
Mailing Address - Country:US
Mailing Address - Phone:877-800-5722
Mailing Address - Fax:512-869-2940
Practice Address - Street 1:11111 RESEARCH BLVD STE 230
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5791
Practice Address - Country:US
Practice Address - Phone:877-800-5722
Practice Address - Fax:512-605-6396
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX446861363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1897399-02Medicaid