Provider Demographics
NPI:1003325465
Name:GRIFFIN, PHOEBE W (APRN)
Entity Type:Individual
Prefix:MRS
First Name:PHOEBE
Middle Name:W
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 MAZATLAN DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-6613
Mailing Address - Country:US
Mailing Address - Phone:214-402-4174
Mailing Address - Fax:
Practice Address - Street 1:7108 ENVOY CT
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-5102
Practice Address - Country:US
Practice Address - Phone:214-956-6995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135180363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily