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General NPI Number Information
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NPI Number | 1043349210
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Entity Type | Organization
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Legal Business Name | ANIMA LLC
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 150 PLAZA DR STE F
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City | LIBERAL
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State | KS
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Zip | 67901-2779
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Country | US
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Telephone | 620-624-2900
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Fax | 620-624-4050
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Provider Business Mailing Address
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Address Line | 150 PLAZA DR STE F
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City | LIBERAL
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State | KS
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Zip | 67901-2779
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Country | US
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Telephone | 620-624-2900
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Fax | 620-624-4050
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Authorized Official
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Title or Position | OWNER
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Name | MS. ALICE JOYCE GRIFFITT
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Credential | ARNP
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Telephone | 620-624-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 74614
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License Number State | KS
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