Healthcare Provider Details

I. General information

NPI: 1851872279
Provider Name (Legal Business Name): GILLIAN MARGARET CLIFFORD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 08/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WESTERN WAYNE FAMILY HEALTH CENTERS 2700 HAMLIN BLVD.
INKSTER MI
48141
US

IV. Provider business mailing address

27140 CLAIRVIEW DR
DEARBORN HEIGHTS MI
48127-1679
US

V. Phone/Fax

Practice location:
  • Phone: 313-561-5100
  • Fax: 313-565-0309
Mailing address:
  • Phone: 313-231-1887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704235517
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: