Provider Demographics
NPI:1326061193
Name:GRIGGS, VELMA ANN (RN CNP)
Entity Type:Individual
Prefix:
First Name:VELMA
Middle Name:ANN
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:RN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 WOODWINDS DR STE 300
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2526
Mailing Address - Country:US
Mailing Address - Phone:651-265-6722
Mailing Address - Fax:
Practice Address - Street 1:2101 WOODWINDS DR STE 300
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2526
Practice Address - Country:US
Practice Address - Phone:651-265-6722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR100687-0363LX0001X, 363L00000X
CA717157363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN919616100Medicaid
MN919616100Medicaid
Q01008Medicare UPIN