# CARISSA MARIE CARDIFF

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1275247199
- **Gender:** F
- **Credential:** APRN-FNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | RN-190701 | MT | — |
| 207Q00000X | Family Medicine Physician | NUR-APRN-LIC-212012 | MT | Yes |

## Other

- **Enumeration date:** 01/06/2023
- **Last updated:** 08/15/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 61440003 | WASHINGTON STATE DEPARTMENT OF HEALTH | WA |