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NPI Code Detail

MEDICARE: DOROTHY J GRIGGS NP

MEDICARE:   DOROTHY J GRIGGS  NP
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
1363L00000XNurse Practitioner865102FL

General Provider Information

NPI Number : 1528169919
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOROTHY J GRIGGS NP
Provider Business Mailing Address
First Line : PO BOX 67
Second Line :
City : GAINESVILLE
State : FL
Zip : 32602-0067
Country : US
Telephone Number : 352-395-6618
Fax Number :
Provider Business Practice Location Address
First Line : 1608 SW ARCHER ROAD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608
Country : US
Telephone Number : 352-376-1611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 07/08/2007

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