Provider Demographics
NPI:1952566390
Name:GRIFFIN, EMILY JANE (FNP-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JANE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4118 WESTLAWN S
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1100
Mailing Address - Country:US
Mailing Address - Phone:319-248-1267
Mailing Address - Fax:888-674-8344
Practice Address - Street 1:4118 WESTLAWN S
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1100
Practice Address - Country:US
Practice Address - Phone:319-248-1267
Practice Address - Fax:888-674-8344
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-099076363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1952566390Medicaid
IAI1416011Medicare PIN
UT005592610Medicare PIN
IAI1421022Medicare PIN