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General NPI Number Information
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NPI Number | 1407366164
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Entity Type | Individual
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Provider Name | CORTNEY SHANA GRIFFIN APN
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Gender | Female
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 12/30/2020
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Provider Practice Location Address
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Address Line | 310 CREEK CROSSING BLVD
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City | HAINESPORT
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State | NJ
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Zip | 08036-2767
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Country | US
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Telephone | 609-702-0014
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Fax | 609-702-7225
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-355-0340
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Fax | 856-355-0330
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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 | 26NJ00701900
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License Number State | NJ
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