Healthcare Provider Details

I. General information

NPI: 1457209553
Provider Name (Legal Business Name): HANNA GRIFFIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNA MARIE WILBERSHIDE

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 MORRIS RD STE C
SHELBY OH
44875-1170
US

IV. Provider business mailing address

DEPT L-3652
COLUMBUS OH
43260-3652
US

V. Phone/Fax

Practice location:
  • Phone: 419-342-2900
  • Fax: 419-342-2902
Mailing address:
  • Phone: 614-544-6366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number465197
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0042434
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: