Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 558761 | TX |
NPI | 1033541123 |
---|---|
Provider Name | Mrs. Kimberly Ann Griffith |
First Address | Dallas, TX 75246-1428 |
Second Address | Dallas, TX 75246-1428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2013 |
Last Update Date | 31/07/2013 |