Provider Demographics
NPI:1518437284
Name:GRIFFITH, KASEY (NP)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:GRIFFITH
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 1:18479 CORTES CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34610-0129
Mailing Address - Country:US
Mailing Address - Phone:812-820-3888
Mailing Address - Fax:
Practice Address - Street 1:3381 TOWN AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-2168
Practice Address - Country:US
Practice Address - Phone:888-644-1448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71008612A363LF0000X
FL11004305363LF0000X
FL9520234163W00000X
IN28202517A163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical