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General NPI Number Information
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NPI Number | 1467615872
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Entity Type | Individual
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Provider Name | MARY CLIFFORD ANP
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Gender | Female
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 3141 N 3RD AVE STE 199
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City | PHOENIX
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State | AZ
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Zip | 85013-4351
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Country | US
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Telephone | 602-745-7951
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Fax |
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Provider Business Mailing Address
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Address Line | 3745 E GLADE AVE
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City | MESA
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State | AZ
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Zip | 85206-3233
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Country | US
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Telephone | 480-832-2809
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | A0604104
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License Number State | AZ
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