Healthcare Provider Details

I. General information

NPI: 1487862710
Provider Name (Legal Business Name): NANCY ANNE GRIFFITH R.N.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1047 R ST
FRESNO CA
93721-1312
US

IV. Provider business mailing address

2034 E EL PASO AVE
FRESNO CA
93720-0218
US

V. Phone/Fax

Practice location:
  • Phone: 559-499-1690
  • Fax: 559-499-1697
Mailing address:
  • Phone: 559-284-4798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number450746
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number6253
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: