Provider Demographics
NPI:1528496940
Name:GRIFFITH, JENNIFER JANE (EMT-P)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JANE
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:EMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1178 KINOOLE ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-7206
Mailing Address - Country:US
Mailing Address - Phone:808-333-3504
Mailing Address - Fax:808-935-4903
Practice Address - Street 1:1178 KINOOLE ST
Practice Address - Street 2:UNIT B
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-7206
Practice Address - Country:US
Practice Address - Phone:808-333-3504
Practice Address - Fax:808-935-4903
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0075054146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic