Individual
RUSSELL GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1978 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 873-2200
Mailing address
602 LOUIS DR, HOUMA, LA 70364-2213
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APO1347
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1905640
—
LA
Enumeration date
12/04/2006
Last updated
07/09/2007
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