Provider Demographics
NPI:1043618358
Name:GRIFFITHS, KATHERINE (PNP, PCNS-BC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:GRIFFITHS
Suffix:
Gender:F
Credentials:PNP, PCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 D L INGRAM AVE W BLDG 1400
Mailing Address - Street 2:
Mailing Address - City:CANNON AFB
Mailing Address - State:NM
Mailing Address - Zip Code:88103-5103
Mailing Address - Country:US
Mailing Address - Phone:575-784-7316
Mailing Address - Fax:
Practice Address - Street 1:208 D L INGRAM AVE W BLDG 1400
Practice Address - Street 2:
Practice Address - City:CANNON AFB
Practice Address - State:NM
Practice Address - Zip Code:88103-5103
Practice Address - Country:US
Practice Address - Phone:575-784-7316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16348364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics