Provider Demographics
NPI:1558871814
Name:GRIFFY, BALLINA HANEY (NP-C)
Entity Type:Individual
Prefix:
First Name:BALLINA
Middle Name:HANEY
Last Name:GRIFFY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:BALLINA
Other - Middle Name:SHERIKA
Other - Last Name:HANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:80 HUMPHREYS CENTER DR STE 210
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2353
Practice Address - Country:US
Practice Address - Phone:901-761-3900
Practice Address - Fax:901-578-2572
Is Sole Proprietor?:No
Enumeration Date:2017-10-01
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN22855363LF0000X
TNRN174066163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse