Provider Demographics
NPI:1316108699
Name:GRIFFIN, CAROLYNN HOCKENBURY (LPN)
Entity type:Individual
Prefix:MS
First Name:CAROLYNN
Middle Name:HOCKENBURY
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 SOUTH RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526
Mailing Address - Country:US
Mailing Address - Phone:919-656-8979
Mailing Address - Fax:919-552-2583
Practice Address - Street 1:4425 SOUTH RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526
Practice Address - Country:US
Practice Address - Phone:919-656-8979
Practice Address - Fax:919-552-2583
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC058287164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse