Healthcare Provider Details

I. General information

NPI: 1376237990
Provider Name (Legal Business Name): CORTNEY GRIFFIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4995 BRADENTON AVE STE 130
DUBLIN OH
43017-3551
US

IV. Provider business mailing address

4995 BRADENTON AVE
DUBLIN OH
43017-3543
US

V. Phone/Fax

Practice location:
  • Phone: 614-580-6917
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0033983
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: