Provider Demographics
NPI:1801500715
Name:TARDIF, CORINTH (ARNP)
Entity type:Individual
Prefix:
First Name:CORINTH
Middle Name:
Last Name:TARDIF
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CORI
Other - Middle Name:
Other - Last Name:TARDIF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, ARNP
Mailing Address - Street 1:2816 CHELAN LOOP
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4185
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6351 W RIO GRANDE AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7634
Practice Address - Country:US
Practice Address - Phone:509-543-9280
Practice Address - Fax:509-579-5915
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61373007363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner