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NPI Code Detail

MEDICARE: ELIZABETH L GRIFFIN CRNA

MEDICARE: ELIZABETH L GRIFFIN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist1-018523AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1051534039OTHERALARM #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053307868
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH L GRIFFIN CRNA
Provider Business Mailing Address
First Line : PO BOX 1123
Second Line :
City : JACKSON
State : MI
Zip : 49204-1123
Country : US
Telephone Number : 800-242-1131
Fax Number :
Provider Business Practice Location Address
First Line : 810 SAINT VINCENTS DR
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35205-1601
Country : US
Telephone Number : 250-939-7143
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2005
Last Update Date : 06/22/2010

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