Healthcare Provider Details

I. General information

NPI: 1548229784
Provider Name (Legal Business Name): JUDITH D GRIFFITH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 12/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 TURNPIKE AVE
CLEARFIELD PA
16830-1232
US

IV. Provider business mailing address

809 TURNPIKE AVE P O BOX 687
CLEARFIELD PA
16830-1232
US

V. Phone/Fax

Practice location:
  • Phone: 800-446-5090
  • Fax:
Mailing address:
  • Phone: 800-446-5090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN240774L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: