Provider Demographics
NPI:1558054262
Name:GRIFFIN, RHEANNAH (PA-C)
Entity Type:Individual
Prefix:
First Name:RHEANNAH
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PA-C
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 210127
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-0127
Mailing Address - Country:US
Mailing Address - Phone:615-383-2443
Mailing Address - Fax:615-383-0853
Practice Address - Street 1:5653 FRIST BLVD STE 738
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2066
Practice Address - Country:US
Practice Address - Phone:615-320-0007
Practice Address - Fax:615-383-6329
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5541363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical