Provider Demographics
NPI:1962568097
Name:TARDIFF, KATHERINE A (APRN, BC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:TARDIFF
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 NEWLAND RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-2606
Mailing Address - Country:US
Mailing Address - Phone:781-697-7431
Mailing Address - Fax:
Practice Address - Street 1:48 NEWLAND RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-2606
Practice Address - Country:US
Practice Address - Phone:781-697-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA258880363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology