Individual
STACY LYNN GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
5128 E STOP 11 RD STE 34, INDIANAPOLIS, IN 46237-6338
(317) 721-4169
Mailing address
5128 E STOP 11 RD STE 34, INDIANAPOLIS, IN 46237-6338
(317) 225-9611
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28153625A
IN
163WM0102X
Maternal Newborn Registered Nurse
28153625A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71013250B
IN
Other
Enumeration date
09/14/2022
Last updated
02/20/2023
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