Provider Demographics
NPI:1568783132
Name:GRIFFIS, JANETTE (LPN)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:
Last Name:GRIFFIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 PENDLETON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PALISADE
Mailing Address - State:CO
Mailing Address - Zip Code:81526-8625
Mailing Address - Country:US
Mailing Address - Phone:928-580-9464
Mailing Address - Fax:
Practice Address - Street 1:434 PENDLETON ST APT 2
Practice Address - Street 2:
Practice Address - City:PALISADE
Practice Address - State:CO
Practice Address - Zip Code:81526-8625
Practice Address - Country:US
Practice Address - Phone:928-580-9464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP046236164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLP046236OtherLPN LICENSE