Provider Demographics
NPI:1689803306
Name:GRIFFIN, VERONICA A (APRN FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:A
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 VIRGINIAN COLONY AVE
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2362
Mailing Address - Country:US
Mailing Address - Phone:985-377-2032
Mailing Address - Fax:
Practice Address - Street 1:1226 S. CLEARVIEW PARKWAY
Practice Address - Street 2:1226 S. CLEARVIEW PARKWAY
Practice Address - City:JEFFERSON
Practice Address - State:LA
Practice Address - Zip Code:70123
Practice Address - Country:US
Practice Address - Phone:504-734-0140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN111657163WP0808X
LAF06202226363LF0000X
LA06202226363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAF06202226Medicaid
F06202226OtherAANO