Provider Demographics
NPI:1336621341
Name:GRIFFIN, LITINA MARIE I (RN)
Entity Type:Individual
Prefix:
First Name:LITINA
Middle Name:MARIE
Last Name:GRIFFIN
Suffix:I
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LITINA
Other - Middle Name:MARIE
Other - Last Name:GRYDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1301 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-2826
Mailing Address - Country:US
Mailing Address - Phone:432-967-8314
Mailing Address - Fax:432-550-1717
Practice Address - Street 1:1301 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-2826
Practice Address - Country:US
Practice Address - Phone:432-967-8314
Practice Address - Fax:432-550-1717
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX923747163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse