Provider Demographics
NPI:1639636731
Name:GRIFFITH, PAIGE MARIETTA (CRNP)
Entity Type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:MARIETTA
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2541 FAIT AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3722
Mailing Address - Country:US
Mailing Address - Phone:609-306-9385
Mailing Address - Fax:
Practice Address - Street 1:2541 FAIT AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3722
Practice Address - Country:US
Practice Address - Phone:609-306-9385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR203949363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care