Provider Demographics
NPI:1720754815
Name:CLIFTON, SHAWNA DIANE (RN)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:DIANE
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 MANCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03064-8111
Mailing Address - Country:US
Mailing Address - Phone:603-966-4145
Mailing Address - Fax:603-594-4413
Practice Address - Street 1:207 MANCHESTER ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064-8111
Practice Address - Country:US
Practice Address - Phone:603-966-4145
Practice Address - Fax:603-594-4413
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH71944-21163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool