Provider Demographics
NPI:1457194185
Name:GRIFFIN, MERCEDES LEE
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:LEE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26560 TAFT RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1031
Mailing Address - Country:US
Mailing Address - Phone:248-396-4691
Mailing Address - Fax:
Practice Address - Street 1:64 W YPSILANTI AVE
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48340-1871
Practice Address - Country:US
Practice Address - Phone:248-396-4691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider