Individual
JARED BLAKE GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NNP-BC
Contact information
Practice address
100 HILLCREST MEDICAL BLVD, WACO, TX 76712-8897
(254) 202-2900
Mailing address
PO BOX 848491, DALLAS, TX 75284-8491
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
AP141025
TX
Other
Enumeration date
12/31/2018
Last updated
01/04/2022
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