Healthcare Provider Details

I. General information

NPI: 1104503044
Provider Name (Legal Business Name): WENDY ANN CLIFTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/03/2023
Certification Date: 07/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9050 E ZEBULON CIR
PARKER CO
80134-5730
US

IV. Provider business mailing address

9050 E ZEBULON CIR
PARKER CO
80134-5730
US

V. Phone/Fax

Practice location:
  • Phone: 303-981-1925
  • Fax:
Mailing address:
  • Phone: 303-981-1925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number91918
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: