Healthcare Provider Details

I. General information

NPI: 1396460648
Provider Name (Legal Business Name): ROBBYN GRIFFIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 STUBBS AVE
MONROE LA
71201-5622
US

IV. Provider business mailing address

1210 STUBBS AVE
MONROE LA
71201-5622
US

V. Phone/Fax

Practice location:
  • Phone: 318-325-8748
  • Fax: 318-325-8749
Mailing address:
  • Phone: 318-325-8748
  • Fax: 318-325-8749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: