Healthcare Provider Details

I. General information

NPI: 1346612306
Provider Name (Legal Business Name): F. NDIDI UCHE GRIFFIN-MYERS IV F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: F. NDIDI UCHE GRIFFIN FNP

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 10/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4441 E KINGS CANYON RD
FRESNO CA
93702-3604
US

IV. Provider business mailing address

9759 N WILLEY CT
FRESNO CA
93720-5416
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-4099
  • Fax: 559-455-4743
Mailing address:
  • Phone: 559-930-2496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3238
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number320766
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: