Provider Demographics
NPI:1619218518
Name:GRIFFIN, NATASHA LANA (RN-BSN)
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:LANA
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24240 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-3831
Mailing Address - Country:US
Mailing Address - Phone:313-207-8964
Mailing Address - Fax:
Practice Address - Street 1:24240 HARRISON ST
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-3831
Practice Address - Country:US
Practice Address - Phone:313-207-8964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704279127163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse