MEDICARE: NANCY E GRIFFIS CNM

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	163WM0102X	Maternal Newborn Registered Nurse	0934643	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0934632	OTHER	FL	ARNP LICENSE NUMBER

General Provider Information

NPI Number	:	1629074521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY E GRIFFIS CNM

Provider Business Mailing Address
First Line	:	3539 EMERALD OAKS DR
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-8436
Country	:	US
Telephone Number	:	954-989-7870
Fax Number	:	954-989-7870

Provider Business Practice Location Address
First Line	:	WOMEN'S HOSPITAL CENTER, ET 3003
Second Line	:	1611 NW 12 STREET
City	:	MIAMI
State	:	FL
Zip	:	33136
Country	:	US
Telephone Number	:	305-585-5116
Fax Number	:

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	07/08/2007

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