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NPI Code Detail

MEDICARE: SHENETTA GRIFFITH RN

MEDICARE: SHENETTA GRIFFITH RN
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
1163W00000XRegistered NurseRN1606502FL

General Provider Information

NPI Number : 1639298292
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHENETTA GRIFFITH RN
Provider Business Mailing Address
First Line : 2950 SE FARLEY RD
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34952-5820
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2950 SE FARLEY RD
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34952-5820
Country : US
Telephone Number : 772-335-0980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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Directions to “ SHENETTA GRIFFITH RN” Practice Location

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