1952691560 NPI number — MS. KATHRYN ELAINE GRIFFITH ARNP, PMHNP-B.C.

Table of content: MS. KATHRYN ELAINE GRIFFITH ARNP, PMHNP-B.C. (NPI 1952691560)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952691560 NPI number — MS. KATHRYN ELAINE GRIFFITH ARNP, PMHNP-B.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIFFITH
Provider First Name:
KATHRYN
Provider Middle Name:
ELAINE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP, PMHNP-B.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:
1952691560
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 37
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LE CLAIRE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52753-0037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-949-5938
Provider Business Mailing Address Fax Number:
877-425-4064

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
419 N CODY ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LECLAIRE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52753-9537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-949-5938
Provider Business Practice Location Address Fax Number:
877-425-4064
Provider Enumeration Date:
04/15/2011

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: 363LP0808X , with the licence number:  G061979 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: G-061979 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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