Provider Demographics
NPI:1578093035
Name:GOLDEN GRIFFITH, IRIS LAKEITH
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:LAKEITH
Last Name:GOLDEN GRIFFITH
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:IRIS
Other - Middle Name:
Other - Last Name:LOCKHEART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8305 OXFORD VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MABELVALE
Mailing Address - State:AR
Mailing Address - Zip Code:72103-2332
Mailing Address - Country:US
Mailing Address - Phone:501-350-9315
Mailing Address - Fax:
Practice Address - Street 1:8305 OXFORD VALLEY DR
Practice Address - Street 2:
Practice Address - City:MABELVALE
Practice Address - State:AR
Practice Address - Zip Code:72103-2332
Practice Address - Country:US
Practice Address - Phone:501-350-9315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR070895163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management