Provider Demographics
NPI:1386416303
Name:GRIGGS-MILLER, SHANNON (PMHNP)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:GRIGGS-MILLER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6605 LOVE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4916
Mailing Address - Country:US
Mailing Address - Phone:704-737-5370
Mailing Address - Fax:
Practice Address - Street 1:714 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-5412
Practice Address - Country:US
Practice Address - Phone:866-495-3651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCGRIG-F5CNE363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health