1386683514 NPI number — TAMI JOI GRIFFITH FNP

Table of content: TAMI JOI GRIFFITH FNP (NPI 1386683514)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386683514 NPI number — TAMI JOI GRIFFITH FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIFFITH
Provider First Name:
TAMI
Provider Middle Name:
JOI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GRIFFITH
Provider Other First Name:
TAMI
Provider Other Middle Name:
MURPHREE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CFNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1386683514
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/14/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 SIPPRELLE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARACHUTE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81635-9234
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-625-6496
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 SIPPRELLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARACHUTE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81635-9234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-625-6496
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/05/2006

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: 363LF0000X , with the licence number:  APN-0004887-NP , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5186516 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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