Provider Demographics
NPI:1609848506
Name:GRIFFIN, PAMELA REGINA (ARNP)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:REGINA
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:UFJP WINTER HAVEN
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-3199
Mailing Address - Fax:904-244-3425
Practice Address - Street 1:200 AVENUE F NE
Practice Address - Street 2:WINTER HAVEN HOSPITAL
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4131
Practice Address - Country:US
Practice Address - Phone:863-293-1121
Practice Address - Fax:863-292-4103
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9166302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3065154-00Medicaid
FL3065154-00Medicaid
FLP00375171Medicare PIN
FLU6252ZMedicare PIN