Provider Demographics
NPI:1568688141
Name:GRIFFIN, ELIANA N (MSN-ANP)
Entity Type:Individual
Prefix:MRS
First Name:ELIANA
Middle Name:N
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MSN-ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 E BROADWAY BLVD
Mailing Address - Street 2:A-100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3640
Mailing Address - Country:US
Mailing Address - Phone:520-327-0460
Mailing Address - Fax:520-795-0225
Practice Address - Street 1:6236 E PIMA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-3154
Practice Address - Country:US
Practice Address - Phone:520-327-6874
Practice Address - Fax:520-327-0028
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN077869163W00000X
AZAP3422363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ131897OtherPTAN