MEDICARE: KASEY GRIFFITH NP

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	363LF0000X	Family Nurse Practitioner	71008612A	IN
2	363LF0000X	Family Nurse Practitioner	11004305	FL
3	163W00000X	Registered Nurse	9520234	FL
4	163WM0705X	Medical-Surgical Registered Nurse	28202517A	IN

General Provider Information

NPI Number	:	1518437284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASEY GRIFFITH NP

Provider Business Mailing Address
First Line	:	18479 CORTES CREEK BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34610-0129
Country	:	US
Telephone Number	:	812-820-3888
Fax Number	:

Provider Business Practice Location Address
First Line	:	3381 TOWN AVE
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-2168
Country	:	US
Telephone Number	:	888-644-1448
Fax Number	:

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

Provider Enumeration Date	:	11/26/2018
Last Update Date	:	10/02/2020

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