Provider Demographics
NPI:1558968271
Name:GRIFFIN, DANA MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:MARIE
Other - Last Name:YARBROUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9747 HARBOR MIST LN
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-1836
Mailing Address - Country:US
Mailing Address - Phone:678-588-2553
Mailing Address - Fax:
Practice Address - Street 1:9747 HARBOR MIST LN
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-1836
Practice Address - Country:US
Practice Address - Phone:678-588-2553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC089074164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse