Provider Demographics
NPI:1477021079
Name:GRIFFIN, CHRISTINA JOY (NP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:JOY
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29334 RAMBLING RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5724
Mailing Address - Country:US
Mailing Address - Phone:313-334-2877
Mailing Address - Fax:
Practice Address - Street 1:38807 ANN ARBOR RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-3896
Practice Address - Country:US
Practice Address - Phone:734-953-6734
Practice Address - Fax:734-953-6738
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704296272363L00000X
MI470477429163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner