Provider Demographics
NPI:1730354044
Name:GRIFFITH, IRENE ELIZABETH (PERS CARE ATTENDENT)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:ELIZABETH
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:PERS CARE ATTENDENT
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:ELIZABETH
Other - Last Name:TINISLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 LINCOLN DRIVE
Mailing Address - Street 2:
Mailing Address - City:RITTMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44270-1194
Mailing Address - Country:US
Mailing Address - Phone:330-925-3537
Mailing Address - Fax:
Practice Address - Street 1:9 LINCOLN DRIVE
Practice Address - Street 2:
Practice Address - City:RITTMAN
Practice Address - State:OH
Practice Address - Zip Code:44270-1194
Practice Address - Country:US
Practice Address - Phone:330-925-3537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2804228Medicaid