Provider Demographics
NPI:1811534563
Name:GRIFFIS, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:GRIFFIS
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 1:12160 RADISSON RD NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-5426
Mailing Address - Country:US
Mailing Address - Phone:952-221-9699
Mailing Address - Fax:
Practice Address - Street 1:12160 RADISSON RD. NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-5426
Practice Address - Country:US
Practice Address - Phone:952-221-9699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula