Provider Demographics
NPI:1518005578
Name:GRIFFIN, NANCY JEAN (NP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JEAN
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 1:2101 SCARLETT DR
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4527
Mailing Address - Country:US
Mailing Address - Phone:757-408-2165
Mailing Address - Fax:
Practice Address - Street 1:16 OLD BROOKSIDE RD
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-3617
Practice Address - Country:US
Practice Address - Phone:973-895-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165219363LF0000X
NJ26NJ00625900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily