Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 3010934 | KY |
N | 363LA2100X | Nurse Practitioner - Acute Care | 3010934 | KY |
NPI | 1003352626 |
---|---|
Provider Name | Holly Marie Griffin |
First Address | Greenville, KY 42345-3070 |
Second Address | Madisonville, KY 42431-1282 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2017 |
Last Update Date | 07/12/2021 |