Provider Demographics
NPI:1750384012
Name:GRIGGS, JOHN M (DNP, FNP-C, CDCES)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:GRIGGS
Suffix:
Gender:M
Credentials:DNP, FNP-C, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 E HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:PORT ST JOE
Mailing Address - State:FL
Mailing Address - Zip Code:32456-5318
Mailing Address - Country:US
Mailing Address - Phone:850-229-5601
Mailing Address - Fax:850-229-5609
Practice Address - Street 1:3801 E HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:PORT ST JOE
Practice Address - State:FL
Practice Address - Zip Code:32456-5318
Practice Address - Country:US
Practice Address - Phone:850-568-1053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1947622163WD0400X
FLAPRN11014716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00625822OtherMEDICARE RAIL ROAD
FLP933395Medicare UPIN
FLAJ564Medicare PIN
FLP00625822OtherMEDICARE RAIL ROAD
FLY9912ZMedicare ID - Type Unspecified