Provider Demographics
NPI:1780290262
Name:GRIFFITHS, SHAMONA NOPHESIA (CRNP)
Entity type:Individual
Prefix:
First Name:SHAMONA
Middle Name:NOPHESIA
Last Name:GRIFFITHS
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6158 HASBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-5921
Mailing Address - Country:US
Mailing Address - Phone:267-595-2572
Mailing Address - Fax:
Practice Address - Street 1:6158 HASBROOK AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-5921
Practice Address - Country:US
Practice Address - Phone:267-595-2572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-19
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR22025500163W00000X
PARN736861363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse