Provider Demographics
NPI:1346803343
Name:GRIFFIN, KATRINA JEAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:JEAN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:JEAN
Other - Last Name:DENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4338 FORT HUGER DR
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-5364
Mailing Address - Country:US
Mailing Address - Phone:757-542-3888
Mailing Address - Fax:
Practice Address - Street 1:4338 FORT HUGER DR
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-5364
Practice Address - Country:US
Practice Address - Phone:757-542-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177513363L00000X
VA0017145939363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner