Provider Demographics
NPI:1700386646
Name:GRIFFIN, DONNA LAEL (LVN)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LAEL
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-2130
Mailing Address - Country:US
Mailing Address - Phone:325-450-3583
Mailing Address - Fax:
Practice Address - Street 1:2013 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-2130
Practice Address - Country:US
Practice Address - Phone:325-450-3583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX307853164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse