Healthcare Provider Details

I. General information

NPI: 1316995061
Provider Name (Legal Business Name): KATHERINE L GRIFFITH RN/APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 NASHVILLE HWY
COLUMBIA TN
38401-2069
US

IV. Provider business mailing address

1600 NASHVILLE HWY
COLUMBIA TN
38401-2069
US

V. Phone/Fax

Practice location:
  • Phone: 931-388-8965
  • Fax: 931-388-0815
Mailing address:
  • Phone: 931-388-8965
  • Fax: 931-388-0815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number135819
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number11835
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: