Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | COA.13247-NP | OH |
NPI | 1093075624 |
---|---|
Provider Name | Christina Marie Griggs |
First Address | Fort Wayne, IN 46804-4201 |
Second Address | Akron, OH 44308-1063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2012 |
Last Update Date | 16/05/2012 |