Provider Demographics
NPI:1710159033
Name:GRIFFIN, ANN LACOUTURE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:LACOUTURE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:HOWCOTT
Other - Last Name:LACOUTURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:852 LOWCOUNTRY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3067
Mailing Address - Country:US
Mailing Address - Phone:843-216-3530
Mailing Address - Fax:843-654-9122
Practice Address - Street 1:852 LOWCOUNTRY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3067
Practice Address - Country:US
Practice Address - Phone:843-216-3530
Practice Address - Fax:843-654-9122
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1201363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical