Provider Demographics
NPI:1104808393
Name:GRIFFEE, ANNE MARIE (APRN)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:GRIFFEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:NIMMICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:926 S 16TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5605
Mailing Address - Country:US
Mailing Address - Phone:402-379-0675
Mailing Address - Fax:402-371-5070
Practice Address - Street 1:2425 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4511
Practice Address - Country:US
Practice Address - Phone:402-371-5070
Practice Address - Fax:402-371-5070
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE43239163W00000X
NE110154363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
S97784Medicare UPIN
278920Medicare ID - Type Unspecified