Healthcare Provider Details

I. General information

NPI: 1467836494
Provider Name (Legal Business Name): LAUREN ELIZABETH GRIFFIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN THORNTON NP

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 HEMLOCK ST MSC 117
MACON GA
31201-2102
US

IV. Provider business mailing address

777 HEMLOCK STREET MSC 117
MACON GA
31201-2102
US

V. Phone/Fax

Practice location:
  • Phone: 478-633-1000
  • Fax:
Mailing address:
  • Phone: 478-633-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN212517
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: