Clifford, Theresa Lynn

Clifford, Theresa Lynn is an individual health care provider with primary practice located at 60 Mack Walters Rd , Shelbyville KY 40065-1738. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Clifford, Theresa Lynn can be contacted via phone (502) 633-4622.

Contact Information

Primary practice address
60 Mack Walters Rd Shelbyville KY 40065-1738
Fax: (502) 633-6925
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3002154 Kentucky

Profile Details

NPI number 1316029507
LBN Legal business name Clifford, Theresa Lynn
Credentials F.N.P., A.P.R.N.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Apr 18th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316029507 NPPES
Kentucky Other 000000626807 ANTHEM
Kentucky Other 3722988000 ANTHEM
Kentucky MEDICAID 7100078250 ANTHEM
Kentucky Other 50024463 ANTHEM

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