Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 063139 | MO |
N | 363LN0000X | Nurse Practitioner - Neonatal | 44448 | KS |
NPI | 1134153406 |
---|---|
Provider Name | Mrs. Mary Elizabeth Clifford |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 02/08/2016 |