Provider Demographics
NPI:1740702620
Name:GRIGGS, LORNA MARIE (RN)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:MARIE
Last Name:GRIGGS
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 1:3600 W PIONEER PKWY STE 19
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-4525
Mailing Address - Country:US
Mailing Address - Phone:682-615-1200
Mailing Address - Fax:
Practice Address - Street 1:3600 W PIONEER PKWY STE 19
Practice Address - Street 2:
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-4525
Practice Address - Country:US
Practice Address - Phone:682-238-3328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX863013163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management