Provider Demographics
NPI:1295822823
Name:GRIFFITH, ASHLEY MARIE (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MARIE
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 HIGHWAY 32 EAST
Mailing Address - Street 2:
Mailing Address - City:WATER VALLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38965
Mailing Address - Country:US
Mailing Address - Phone:662-473-5728
Mailing Address - Fax:662-473-5755
Practice Address - Street 1:600 HIGHWAY 32
Practice Address - Street 2:
Practice Address - City:WATER VALLEY
Practice Address - State:MS
Practice Address - Zip Code:38965-6431
Practice Address - Country:US
Practice Address - Phone:662-473-5728
Practice Address - Fax:662-473-5755
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR844428363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS016175275Medicaid
MS016175275Medicaid