Healthcare Provider Details

I. General information

NPI: 1427427517
Provider Name (Legal Business Name): PAIGE MICHELLE CLIFTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2015
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 SMITH ST
LAGRANGE GA
30240-2745
US

IV. Provider business mailing address

303 SMITH ST
LAGRANGE GA
30240-2745
US

V. Phone/Fax

Practice location:
  • Phone: 706-882-8831
  • Fax:
Mailing address:
  • Phone: 706-882-8831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP176214
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN-NP176214
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP176214
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: