Provider Demographics
NPI:1891163846
Name:GRIFFETH, MIRANDA (CNM, WHNP-BC)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:GRIFFETH
Suffix:
Gender:
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:
Other - Last Name:DIMMERLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM, WHNP-BC
Mailing Address - Street 1:1300 UPPER HEMBREE RD STE C
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-0927
Mailing Address - Country:US
Mailing Address - Phone:404-381-2297
Mailing Address - Fax:
Practice Address - Street 1:1300 UPPER HEMBREE RD STE C
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-0927
Practice Address - Country:US
Practice Address - Phone:404-255-8022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN251255367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife