Provider Demographics
NPI:1497328686
Name:GRIFFITH, REBIE LATOYA (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:REBIE
Middle Name:LATOYA
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21213 HAWTHORNE BLVD # 5407
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5595
Mailing Address - Country:US
Mailing Address - Phone:559-942-0164
Mailing Address - Fax:
Practice Address - Street 1:255 E DEL AMO BLVD APT 101
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-3851
Practice Address - Country:US
Practice Address - Phone:559-942-0164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027206363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily