Provider Demographics
NPI:1316094691
Name:GRIFFITH, NOEL C (AUD)
Entity type:Individual
Prefix:MS
First Name:NOEL
Middle Name:C
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:NOEL
Other - Middle Name:C
Other - Last Name:BOORTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:555 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2136
Mailing Address - Country:US
Mailing Address - Phone:402-280-8100
Mailing Address - Fax:402-280-8103
Practice Address - Street 1:555 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2136
Practice Address - Country:US
Practice Address - Phone:402-498-6540
Practice Address - Fax:402-498-6357
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE243231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2717967Medicaid
NE37019OtherBCBS ENT
IA0717694Medicaid
IA7717694Medicaid
IA9717694Medicaid
IA0717967Medicaid
IA1717694Medicaid
IA6717694Medicaid
IA5717694Medicaid
IA3717694Medicaid
IA4717694Medicaid
IA1717967Medicaid
IA2717694Medicaid
IA4717694Medicaid
IA7717694Medicaid