1376532242 NPI number — MS. SARAH LOUISE GRIFFIN M.S., C.G.C.

Table of content: MS. SARAH LOUISE GRIFFIN M.S., C.G.C. (NPI 1376532242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376532242 NPI number — MS. SARAH LOUISE GRIFFIN M.S., C.G.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIFFIN
Provider First Name:
SARAH
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., C.G.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376532242
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 OSBORNE RD NE
Provider Second Line Business Mailing Address:
INTERNAL ZIP 52790
Provider Business Mailing Address City Name:
FRIDLEY
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55432-2718
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-236-4645
Provider Business Mailing Address Fax Number:
763-236-3010

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
550 OSBORNE RD NE
Provider Second Line Business Practice Location Address:
INTERNAL ZIP 52790
Provider Business Practice Location Address City Name:
FRIDLEY
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55432-2718
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-236-4645
Provider Business Practice Location Address Fax Number:
763-236-3010
Provider Enumeration Date:
10/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 170300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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