Healthcare Provider Details

I. General information

NPI: 1366508780
Provider Name (Legal Business Name): SUSAN KATHERINE GRIFFETH ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN KATHERINE NOTTE

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 BAPTIST HEALTH DR STE 600
LITTLE ROCK AR
72205-6231
US

IV. Provider business mailing address

9501 BAPTIST HEALTH DR STE 600
LITTLE ROCK AR
72205-6231
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-7596
  • Fax: 501-219-8633
Mailing address:
  • Phone: 501-227-7596
  • Fax: 501-219-8633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN131706
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2008019966
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberA004488
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: