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General NPI Number Information
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NPI Number | 1093209645
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Entity Type | Individual
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Provider Name | MAKENZIE R. GRIFFIN FNP
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Gender | Female
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 985 PRINCE FREDERICK BLVD SUITE 201
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-3492
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Country | US
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Telephone | 410-535-2005
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Fax | 410-535-4850
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Provider Business Mailing Address
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Address Line | 205 STEEPLE CHASE DRIVE SUITE 304
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4054
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Country | US
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Telephone | 410-535-2005
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Fax | 443-432-3683
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R209597
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11018528
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 343144
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License Number State | NY
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