Provider Demographics
NPI:1881497550
Name:GRIFFIN-GREAUX, CONSINA A
Entity type:Individual
Prefix:
First Name:CONSINA
Middle Name:A
Last Name:GRIFFIN-GREAUX
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 TRAIL BLAZER DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32310-3648
Mailing Address - Country:US
Mailing Address - Phone:850-559-7114
Mailing Address - Fax:
Practice Address - Street 1:1421 TRAIL BLAZER DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32310-3648
Practice Address - Country:US
Practice Address - Phone:850-559-7114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLG615101739576372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion