Provider Demographics
NPI:1689483380
Name:CLIFTON, LAURA LUCIA (DNP, MSN, RN)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:LUCIA
Last Name:CLIFTON
Suffix:
Gender:
Credentials:DNP, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 WINSLOW LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4651
Mailing Address - Country:US
Mailing Address - Phone:713-449-7713
Mailing Address - Fax:
Practice Address - Street 1:2212 WINSLOW LN
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-4651
Practice Address - Country:US
Practice Address - Phone:713-449-7713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX642464163WM0102X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171M00000XMedicaid