MEDICARE: CASSIE I GIFFORD ARNP-FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0991515	CO

General Provider Information

NPI Number	:	1881970622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSIE I GIFFORD ARNP-FNP-C

Provider Business Mailing Address
First Line	:	11371 ARBOR ST APT L307
Second Line	:
City	:	FIRESTONE
State	:	CO
Zip	:	80504-6900
Country	:	US
Telephone Number	:	785-640-7962
Fax Number	:

Provider Business Practice Location Address
First Line	:	132 CHESTERFIELD TOWNE CTR
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63005-1230
Country	:	US
Telephone Number	:	785-640-7962
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2011
Last Update Date	:	04/13/2023

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