Tara Griffin
Individual provider Active NPI Licensed Practical Nurse · Waterville, NY
NPI 1114764693 · NPPES record last updated Jul 11, 2024
Key facts
- NPI
- 1114764693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 306529-01 (NY)
- Practice address
- 7068 Sanger Hill Rd
Waterville, NY 13480-1916 - Phone
- (315) 404-1785
- NPI assigned
- Jul 11, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 306529-01 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 306529-01 | NY | Yes |
Addresses
Primary practice location
7068 Sanger Hill Rd
Waterville, NY 13480-1916
Mailing address
7068 Sanger Hill Rd
Waterville, NY 13480-1916
Phone (315) 404-1785
Other providers in Waterville, NY
- Community Memorial Hospital
- Nannette S Cowen
- CVS Albany, L.L.C.
- Austin Drake
- James Gilchrist
- Isaiah J Hammonds
- Harding Nursing Home, LLC
- Muhammad Harfoush
- Sean James Hopkins
- Kerri Hudson
All providers in Waterville, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.