Individual
MRS. MANDA SUE GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
400 THIRD AVENUE HIGHWAY 32 WEST, HOULKA, MS 38850-9004
(662) 568-2013
(662) 568-2023
Mailing address
400 THIRD AVENUE HIGHWAY 32 WEST, HOULKA, MS 38850-9004
(662) 568-2013
(662) 568-2023
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R850148
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04506555
—
MS
01
—
R850148
FNP
MS
Enumeration date
01/31/2007
Last updated
07/26/2017
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