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General NPI Number Information
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NPI Number | 1083712673
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Entity Type | Individual
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Provider Name | DIANE M. DENNIS-GRIGGS NP
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 80 JESSE HILL JR DR SE
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City | ATLANTA
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State | GA
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Zip | 30303-3031
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Country | US
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Telephone | 404-616-7626
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Fax | 404-756-1402
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Provider Business Mailing Address
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Address Line | 720 WESTVIEW DR SW HARRIS BUILDING, SUITE 100-A
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City | ATLANTA
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State | GA
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Zip | 30310-1458
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Country | US
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Telephone | 404-756-1400
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Fax | 404-756-1402
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN152771
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License Number State | GA
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