Healthcare Provider Details

I. General information

NPI: 1902027386
Provider Name (Legal Business Name): TRUETT BARRON CLIFTON WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRUDY BARRON CLIFTON WHNP

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11111 RESEARCH BLVD STE 230
AUSTIN TX
78759-5791
US

IV. Provider business mailing address

205 E UNIVERSITY AVE STE 200
GEORGETOWN TX
78626-6821
US

V. Phone/Fax

Practice location:
  • Phone: 877-800-5722
  • Fax: 512-605-6396
Mailing address:
  • Phone: 877-800-5722
  • Fax: 512-869-2940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number446861
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: