Individual
JACKIE TANNER GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3803 N ELM ST, GREENSBORO, NC 27455-2593
(336) 540-7075
(888) 882-3919
Mailing address
3803 N ELM ST, GREENSBORO, NC 27455-2593
(336) 540-7075
(888) 882-3919
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
900292
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2328528
UNITED HEALTHCARE
—
Enumeration date
12/13/2005
Last updated
06/08/2015
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