Provider Demographics
NPI:1881970622
Name:GIFFORD, CASSIE I (ARNP-FNP-C)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:I
Last Name:GIFFORD
Suffix:
Gender:F
Credentials:ARNP-FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11371 ARBOR ST APT L307
Mailing Address - Street 2:
Mailing Address - City:FIRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:80504-6900
Mailing Address - Country:US
Mailing Address - Phone:785-640-7962
Mailing Address - Fax:
Practice Address - Street 1:132 CHESTERFIELD TOWNE CTR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1230
Practice Address - Country:US
Practice Address - Phone:785-640-7962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0991515363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO395901YLB8Medicare PIN