Provider Demographics
NPI:1396093837
Name:GRIFFIN, SARAH JEAN (PA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JEAN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3311 PRESCOTT RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3983
Mailing Address - Country:US
Mailing Address - Phone:318-442-6767
Mailing Address - Fax:318-441-1358
Practice Address - Street 1:3311 PRESCOTT RD STE 201
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3983
Practice Address - Country:US
Practice Address - Phone:318-442-6767
Practice Address - Fax:318-441-1358
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200582363A00000X
LAPA200582363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant