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Individual

MANDI D GRIFFIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
802 N RIVERSIDE RD.,, STE. 200, SAINT JOSEPH, MO 64506-2553
(816) 271-6666
(816) 271-1300
Mailing address
802 N RIVERSIDE RD STE 200, SAINT JOSEPH, MO 64507-2553
(816) 271-6666
(816) 271-1300

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2002016178
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1366610537
MO
05
200544470B
KS
05
428378301
MO
01
P00858875
RR MEDICARE
MO
Enumeration date
02/11/2008
Last updated
11/21/2017
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