Jennifer Clifford
Individual provider Active NPI Licensed Practical Nurse · Germantown Hills, IL
NPI 1639614894 · NPPES record last updated Dec 27, 2016
Key facts
- NPI
- 1639614894
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 043118080 (IL)
- Practice address
- 401 Currant Dr
Germantown Hills, IL 61548-9299 - Phone
- (309) 437-5498
- NPI assigned
- Dec 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043118080 | IL | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 043118080 | IL | Yes |
Addresses
Primary practice location
401 Currant Dr
Germantown Hills, IL 61548-9299
Mailing address
401 Currant Dr
Germantown Hills, IL 61548-9299
Phone (309) 437-5498
Other providers in Germantown Hills, IL
All providers in Germantown Hills, IL · Licensed Practical Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.