Provider Demographics
NPI:1609573450
Name:GRIFFITH, KEMA (RN)
Entity Type:Individual
Prefix:MR
First Name:KEMA
Middle Name:
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:KEMA
Other - Middle Name:
Other - Last Name:GRIFFITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:133 PROSPECT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-2405
Mailing Address - Country:US
Mailing Address - Phone:201-748-9727
Mailing Address - Fax:
Practice Address - Street 1:133 PROSPECT ST APT 2
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2405
Practice Address - Country:US
Practice Address - Phone:201-748-9727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY756967-01163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health