Healthcare Provider Details

I. General information

NPI: 1295630317
Provider Name (Legal Business Name): JORDAN GRIFFIN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 COMMERCE DR STE 301
DECATUR GA
30030-2627
US

IV. Provider business mailing address

167 WALCILLE LN
MCDONOUGH GA
30252-6690
US

V. Phone/Fax

Practice location:
  • Phone: 404-294-0472
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: