Provider Demographics
NPI:1750941373
Name:GRIFFITH, DEBRA RENEE
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:RENEE
Last Name:GRIFFITH
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 1:90 CAPITOL CT
Mailing Address - Street 2:
Mailing Address - City:FARRELL
Mailing Address - State:PA
Mailing Address - Zip Code:16121-1715
Mailing Address - Country:US
Mailing Address - Phone:878-202-4355
Mailing Address - Fax:
Practice Address - Street 1:90 CAPITOL CT
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-1715
Practice Address - Country:US
Practice Address - Phone:878-202-4355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN324857L163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health