Provider Demographics
NPI:1568830933
Name:GRIFFIN, INITA M (MSN,FNP,PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:INITA
Middle Name:M
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MSN,FNP,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8702 S LANCASTER RD STE 160
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75241-6319
Mailing Address - Country:US
Mailing Address - Phone:469-949-8900
Mailing Address - Fax:214-339-2784
Practice Address - Street 1:8702 S LANCASTER RD STE 160
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75241-6319
Practice Address - Country:US
Practice Address - Phone:469-949-8900
Practice Address - Fax:214-339-2784
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128806363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty