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General NPI Number Information
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NPI Number | 1619177516
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Entity Type | Individual
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Provider Name | TISHA R GRIFFIN CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 431 N CARLISLE ST
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City | ALBERTVILLE
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State | AL
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Zip | 35950-1733
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Country | US
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Telephone | 256-251-2566
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Fax | 256-344-8334
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Provider Business Mailing Address
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Address Line | 431 N CARLISLE ST
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City | ALBERTVILLE
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State | AL
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Zip | 35950-1733
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Country | US
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Telephone | 256-251-2566
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Fax | 256-344-8334
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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 | 1098638
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License Number State | AL
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