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Individual

MRS. KATHLEEN WETHERELL GRIFFIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-9016
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-9016

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5004721
NC
363LP0200X
Pediatric Nurse Practitioner
Primary
5004721
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7000836
NC
Enumeration date
01/31/2007
Last updated
11/15/2010
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