Provider Demographics
NPI:1639160120
Name:GRIFFITH, LINDA H (APN NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:H
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:APN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3799
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-3799
Mailing Address - Country:US
Mailing Address - Phone:931-245-8500
Mailing Address - Fax:931-245-7068
Practice Address - Street 1:141 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5093
Practice Address - Country:US
Practice Address - Phone:931-245-8500
Practice Address - Fax:931-245-7068
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5655APN363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3908556Medicaid
TN3908556Medicare ID - Type Unspecified
P22130Medicare UPIN
TN3908556Medicaid