MEDICARE: EMILY JANE GRIFFIN FNP-C

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	363LF0000X	Family Nurse Practitioner	A-099076	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952566390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY JANE GRIFFIN FNP-C

Provider Business Mailing Address
First Line	:	4118 WESTLAWN S
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1100
Country	:	US
Telephone Number	:	319-248-1267
Fax Number	:	888-674-8344

Provider Business Practice Location Address
First Line	:	4118 WESTLAWN S
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1100
Country	:	US
Telephone Number	:	319-248-1267
Fax Number	:	888-674-8344

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

Provider Enumeration Date	:	07/24/2008
Last Update Date	:	09/20/2013

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