Provider Demographics
NPI:1407136450
Name:GRIFFIN, SHENIECE LATOYA (RN)
Entity Type:Individual
Prefix:
First Name:SHENIECE
Middle Name:LATOYA
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 1:75 MELROSE ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-1801
Mailing Address - Country:US
Mailing Address - Phone:585-520-6506
Mailing Address - Fax:
Practice Address - Street 1:75 MELROSE ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-1801
Practice Address - Country:US
Practice Address - Phone:585-520-6506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22 631889163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse