MEDICARE: MR. GREGORY F GRIFFETH PMHNP-BC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NUR-APRN-LIC-268394	MT

General Provider Information

NPI Number	:	1366253221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GREGORY F GRIFFETH PMHNP-BC

Provider Business Mailing Address
First Line	:	131 WHISKEY WAY UNIT C
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-1192
Country	:	US
Telephone Number	:	406-540-7235
Fax Number	:	406-797-1597

Provider Business Practice Location Address
First Line	:	131 WHISKEY WAY UNIT C
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-1192
Country	:	US
Telephone Number	:	406-540-7235
Fax Number	:	406-797-1597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2025
Last Update Date	:	03/26/2026

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