Provider Demographics
NPI:1336237577
Name:CLIFFORD, LINDA H (FNP-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:H
Last Name:CLIFFORD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 ROSER TER
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-2313
Mailing Address - Country:US
Mailing Address - Phone:315-339-7556
Mailing Address - Fax:
Practice Address - Street 1:600 SENECA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2668
Practice Address - Country:US
Practice Address - Phone:315-336-6800
Practice Address - Fax:315-338-5408
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA4586Medicare ID - Type Unspecified