Healthcare Provider Details

I. General information

NPI: 1790989408
Provider Name (Legal Business Name): PAMELA ROBIN GRIFFIN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 N SPRING ST
HARRISON AR
72601-2913
US

IV. Provider business mailing address

6194 RIDDLE DR
HARRISON AR
72601-7244
US

V. Phone/Fax

Practice location:
  • Phone: 870-741-2500
  • Fax: 870-741-7618
Mailing address:
  • Phone: 870-743-0005
  • Fax: 870-365-0481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA01877 ANP
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1656962
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: