Provider Demographics
NPI:1326574757
Name:GRIFFIN, LAUREN GRACE (RN)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:GRACE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 PALMETTO ST
Mailing Address - Street 2:APT 2R
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-3196
Mailing Address - Country:US
Mailing Address - Phone:802-558-1245
Mailing Address - Fax:
Practice Address - Street 1:2024 PALMETTO ST
Practice Address - Street 2:APT 2R
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-3196
Practice Address - Country:US
Practice Address - Phone:802-558-1245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY728981163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse