MEDICARE: DANA MAE GRIFFIN DNP, APRN-NP, FNP-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	363L00000X	Nurse Practitioner	113261	NE

General Provider Information

NPI Number	:	1407466972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA MAE GRIFFIN DNP, APRN-NP, FNP-BC

Provider Business Mailing Address
First Line	:	3015 N 90TH ST STE 1
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-4713
Country	:	US
Telephone Number	:	402-453-6869
Fax Number	:

Provider Business Practice Location Address
First Line	:	3015 N 90TH ST STE 1
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-4713
Country	:	US
Telephone Number	:	402-453-6869
Fax Number	:

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

Provider Enumeration Date	:	08/08/2020
Last Update Date	:	08/08/2020

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