Provider Demographics
NPI:1649421009
Name:GRIFFIN, RONALD (RN)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WICKHAM FEN RD
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-7534
Mailing Address - Country:US
Mailing Address - Phone:314-766-0386
Mailing Address - Fax:
Practice Address - Street 1:9 WICKHAM FEN RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-7534
Practice Address - Country:US
Practice Address - Phone:314-766-0386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003018713163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency