Provider Demographics
NPI:1720619265
Name:GRIFFIN, STEPHANIE (DNP, RN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:DNP, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 S COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-9712
Mailing Address - Country:US
Mailing Address - Phone:517-204-2074
Mailing Address - Fax:
Practice Address - Street 1:2414 LAKE LANSING RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3618
Practice Address - Country:US
Practice Address - Phone:517-341-4712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704248660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily