Breanna Michelle Griffin
Individual provider Active NPI Registered Dietitian · Park Hills, MO
NPI 1497257588 · NPPES record last updated Mar 5, 2018
Key facts
- NPI
- 1497257588
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2018006930 (MO)
- Practice address
- 1025 W Main St
Park Hills, MO 63601-2079 - Phone
- (573) 854-0053
- NPI assigned
- Mar 5, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 2018006930 | MO | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2018006930 | MO | Yes |
Addresses
Primary practice location
1025 W Main St
Park Hills, MO 63601-2079
Mailing address
505 6TH St
Park Hills, MO 63601-4215
Phone (573) 854-0053
Other providers in Park Hills, MO
- Great Mines Health Center
- Great Mines Health Center
- Great Mines Health Center
- Great Mines Health Center
- Greater Heights RCF, LLC
- Amy Hamann
- Harps Food Stores, Inc
- Jamie Harrel
- Jennifer Hierro
- Gerald Hoeflein
All providers in Park Hills, MO · Registered Dietitian in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2018. 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.