Griffin, Jackie Tanner

Griffin, Jackie Tanner is an individual health care provider with primary practice located at 3803 N Elm St , Greensboro NC 27455-2593. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Griffin, Jackie Tanner can be contacted via phone (336) 540-7075.

Contact Information

Primary practice address
3803 N Elm St Greensboro NC 27455-2593
Phone: (336) 540-7075
Fax: (888) 882-3919
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 900292 North Carolina

Profile Details

NPI number 1316922339
LBN Legal business name Griffin, Jackie Tanner
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Jun 8th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316922339 NPPES
Other 2328528 UNITED HEALTHCARE

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