Provider Demographics
NPI:1154126092
Name:GRIFFIN, MEGAN DENISE (RT (R)(M)(CI) RRA)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:DENISE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:RT (R)(M)(CI) RRA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2785 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-4506
Mailing Address - Country:US
Mailing Address - Phone:505-326-2964
Mailing Address - Fax:
Practice Address - Street 1:2785 PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-4506
Practice Address - Country:US
Practice Address - Phone:505-326-2964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
4462302471C1101X, 2471C3402X, 2471M2300X
NM446230243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant
No2471C1101XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistCardiovascular-Interventional Technology
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
No2471M2300XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMammography