| NPI | 1962845347 |
|---|---|
| Former Name | JACQUELYNN NICHOLE GRIFFIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 50838) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 52530) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2025-03-14 |