Provider Demographics
NPI:1104475425
Name:GRIGGS, KRISTIN ISABEL (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ISABEL
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:ISABEL
Other - Last Name:VON PELSER-BERENSBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8954 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2272
Mailing Address - Country:US
Mailing Address - Phone:943-202-7120
Mailing Address - Fax:470-986-7807
Practice Address - Street 1:8954 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-2272
Practice Address - Country:US
Practice Address - Phone:943-202-7120
Practice Address - Fax:470-986-7807
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical