Provider Demographics
NPI:1851612766
Name:GRIFFIN, JESSICA LYNN (RN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 IVY ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14905-1646
Mailing Address - Country:US
Mailing Address - Phone:607-737-7773
Mailing Address - Fax:607-735-5792
Practice Address - Street 1:602 IVY ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14905-1646
Practice Address - Country:US
Practice Address - Phone:607-737-7773
Practice Address - Fax:607-735-5792
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY595978-1163W00000X
NY595978163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163W00000XNursing Service ProvidersRegistered Nurse