Provider Demographics
NPI:1972252310
Name:GRIFFIN, ELI EUGENE (CRNP)
Entity Type:Individual
Prefix:
First Name:ELI
Middle Name:EUGENE
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2941 POINT MALLARD PKWY SE STE N
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-5760
Mailing Address - Country:US
Mailing Address - Phone:256-432-2822
Mailing Address - Fax:256-432-2825
Practice Address - Street 1:4166 HIGHWAY 36 E
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:AL
Practice Address - Zip Code:35670-5803
Practice Address - Country:US
Practice Address - Phone:256-778-7172
Practice Address - Fax:256-778-8910
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-181055363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care