MEDICARE: WHITNEY GRIFFITH

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	363L00000X	Nurse Practitioner	RN9370630	FL

General Provider Information

NPI Number	:	1578911616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY GRIFFITH

Provider Business Mailing Address
First Line	:	4371 VERONICA S SHOEMAKER BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-2216
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4371 VERONICA S SHOEMAKER BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-2216
Country	:	US
Telephone Number	:	352-369-0181
Fax Number	:	352-369-0246

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

Provider Enumeration Date	:	05/31/2016
Last Update Date	:	05/31/2016

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Directions to “ WHITNEY GRIFFITH ” Practice Location

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