Provider Demographics
NPI:1225881675
Name:GRIFFIN, VINCENTIA (MA, CPT, CNA)
Entity Type:Individual
Prefix:
First Name:VINCENTIA
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MA, CPT, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 AVENUE E
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-5411
Mailing Address - Country:US
Mailing Address - Phone:806-502-3211
Mailing Address - Fax:
Practice Address - Street 1:613 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-4615
Practice Address - Country:US
Practice Address - Phone:806-810-1318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA0061040192376K00000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No376K00000XNursing Service Related ProvidersNurse's Aide