Provider Demographics
NPI:1114269016
Name:GIFFORD, VIRGINIA LYNN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:LYNN
Last Name:GIFFORD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:LYNN
Other - Last Name:REDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:615-425-4268
Practice Address - Street 1:1685 OLD PENDERGRASS RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-2705
Practice Address - Country:US
Practice Address - Phone:706-387-7637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN181533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily