Provider Demographics
NPI:1386712560
Name:GRIFFITH, TRACY COX (A-GNP-C)
Entity type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:COX
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13640 N PLAZA DEL RIO BLVD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4846
Mailing Address - Country:US
Mailing Address - Phone:623-285-0306
Mailing Address - Fax:602-747-3120
Practice Address - Street 1:13640 N PLAZA DEL RIO BLVD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4846
Practice Address - Country:US
Practice Address - Phone:623-285-0306
Practice Address - Fax:602-747-3120
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC19015101YP2500X
TX13622101YP2500X
AZRN171656163W00000X
AZRNP273255363LG0600X
TX614997163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No163W00000XNursing Service ProvidersRegistered Nurse