Provider Demographics
NPI:1649329954
Name:GRIGGS, PATRICIA ANN
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7481 TAHOE LAKE CT
Mailing Address - Street 2:#206
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-7867
Mailing Address - Country:US
Mailing Address - Phone:513-284-8201
Mailing Address - Fax:
Practice Address - Street 1:7481 TAHOE LAKE CT
Practice Address - Street 2:#206
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-7867
Practice Address - Country:US
Practice Address - Phone:513-284-8201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN283920163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2126532Medicaid