Provider Demographics
NPI:1790170371
Name:GRIFFEY, CYNTHIA DIANE (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DIANE
Last Name:GRIFFEY
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800A ROSSVILLE AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-1912
Mailing Address - Country:US
Mailing Address - Phone:423-531-6555
Mailing Address - Fax:423-531-6565
Practice Address - Street 1:1800A ROSSVILLE AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-1912
Practice Address - Country:US
Practice Address - Phone:423-531-6555
Practice Address - Fax:423-531-6565
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN130524363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care