Provider Demographics
NPI:1518672393
Name:GRIFFIN, TAMARA SIMPSON (RN)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:SIMPSON
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:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-0424
Mailing Address - Country:US
Mailing Address - Phone:615-806-4987
Mailing Address - Fax:
Practice Address - Street 1:5 JONES CIR
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-3430
Practice Address - Country:US
Practice Address - Phone:615-806-4987
Practice Address - Fax:615-471-8461
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN108509163WC0400X, 163WD0400X, 163WW0000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health