Provider Demographics
NPI:1114487105
Name:GRIFFIN, RUTH ALLISON (CRNP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ALLISON
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:ALLISON
Other - Last Name:MCMILLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:204 ALLEN MEMORIAL DR STE 201
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:GA
Mailing Address - Zip Code:30110-2062
Mailing Address - Country:US
Mailing Address - Phone:770-537-6500
Mailing Address - Fax:770-824-2600
Practice Address - Street 1:204 ALLEN MEMORIAL DR STE 201
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:GA
Practice Address - Zip Code:30110-2062
Practice Address - Country:US
Practice Address - Phone:770-537-6500
Practice Address - Fax:770-824-2600
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-166658363LF0000X
GARN316673363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily