Individual
NICOLE GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
925 MAIN ST STE 100, PENNSBURG, PA 18073-1631
(267) 923-8646
Mailing address
110 E HOWARD ST, STOWE, PA 19464-6708
(610) 476-9690
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
SP013619
PA
363LP0200X
Pediatric Nurse Practitioner
SP013619
PA
363LP2300X
Primary Care Nurse Practitioner
Primary
SP013619
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018444060004
—
PA
Enumeration date
11/25/2014
Last updated
03/17/2018
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