Provider Demographics
NPI:1770548000
Name:CLIFT, GAIL (RN, PNP)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:CLIFT
Suffix:
Gender:F
Credentials:RN, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 LONAS DR STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2732
Mailing Address - Country:US
Mailing Address - Phone:865-588-3173
Mailing Address - Fax:865-637-4362
Practice Address - Street 1:6305 LONAS DR STE 101
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2732
Practice Address - Country:US
Practice Address - Phone:865-588-3173
Practice Address - Fax:865-637-4362
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN35121363LP0808X
TNAPN0000005174363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3496718Medicaid