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General NPI Number Information
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NPI Number | 1063556363
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Entity Type | Individual
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Provider Name | QUANDA MICHON GRIFFIN NP
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Gender | Female
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | SOUTHEASTERN VIRGINIA HEALTH SYSTEMS-48TH STREET PHYSIC 4714 MARSHALL AVE
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City | NEWPORT NEWS
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State | VA
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Zip | 23608
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Country | US
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Telephone | 757-380-8709
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Fax | 757-952-1345
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Provider Business Mailing Address
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Address Line | 620 JOHN PAUL JONES CIR BLDG 104 NAVAL MEDICAL CENTER PORTSMOUTH
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City | PORTSMOUTH
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State | VA
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Zip | 23708-2111
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Country | US
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Telephone | 757-953-9822
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Fax | 757-953-9999
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 0001150167
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024168269
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License Number State | VA
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