Provider Demographics
NPI:1033541123
Name:GRIFFITH, KIMBERLY ANN (RN, ACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:RN, ACNP-BC
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:HUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4105 JUNIUS ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1428
Mailing Address - Country:US
Mailing Address - Phone:214-824-2744
Mailing Address - Fax:214-823-9951
Practice Address - Street 1:4105 JUNIUS ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1428
Practice Address - Country:US
Practice Address - Phone:214-824-2744
Practice Address - Fax:214-823-9951
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX558761363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care