MEDICARE: MRS. ANNE MARIE GRIFFEE APRN

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	163W00000X	Registered Nurse	43239	NE
2	363L00000X	Nurse Practitioner	110154	NE

General Provider Information

NPI Number	:	1104808393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNE MARIE GRIFFEE APRN

Provider Business Mailing Address
First Line	:	926 S 16TH ST
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-5605
Country	:	US
Telephone Number	:	402-379-0675
Fax Number	:	402-371-5070

Provider Business Practice Location Address
First Line	:	2425 TAYLOR AVE
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-4511
Country	:	US
Telephone Number	:	402-371-5070
Fax Number	:	402-371-5070

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	01/23/2012

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