Provider Demographics
NPI:1790989408
Name:GRIFFIN, PAMELA ROBIN (APN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ROBIN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6194 RIDDLE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-7244
Mailing Address - Country:US
Mailing Address - Phone:870-743-0005
Mailing Address - Fax:870-365-0481
Practice Address - Street 1:724 N SPRING ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2913
Practice Address - Country:US
Practice Address - Phone:870-741-2500
Practice Address - Fax:870-741-7618
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01877 ANP363LF0000X
FL1656962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily