Provider Demographics
NPI:1861253023
Name:GRIFFIN, TERREL MARIE
Entity type:Individual
Prefix:
First Name:TERREL
Middle Name:MARIE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 GROVE NECK RD
Mailing Address - Street 2:
Mailing Address - City:EARLEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21919-3008
Mailing Address - Country:US
Mailing Address - Phone:443-282-1197
Mailing Address - Fax:410-885-4041
Practice Address - Street 1:314 GROVE NECK RD
Practice Address - Street 2:
Practice Address - City:EARLEVILLE
Practice Address - State:MD
Practice Address - Zip Code:21919-3008
Practice Address - Country:US
Practice Address - Phone:443-282-1197
Practice Address - Fax:410-885-4041
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL2-0012659164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse