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General NPI Number Information
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NPI Number | 1740733096
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Entity Type | Individual
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Provider Name | JESSICA GRIFFIN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 01/29/2019
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Provider Practice Location Address
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Address Line | 529 N GALLOWAY AVE SUITE #16
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City | MESQUITE
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State | TX
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Zip | 75149-3420
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Country | US
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Telephone | 972-566-7163
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 SOJOURN DR APT 510C
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City | ADDISON
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State | TX
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Zip | 75001-5006
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Country | US
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Telephone | 314-435-7055
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Fax |
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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 | AP131486
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License Number State | TX
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