Provider Demographics
NPI:1023322021
Name:GRIFFINGER, KERRY LYNN (CRNA)
Entity type:Individual
Prefix:MS
First Name:KERRY
Middle Name:LYNN
Last Name:GRIFFINGER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W 22ND ST
Mailing Address - Street 2:APT. 4W
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2744
Mailing Address - Country:US
Mailing Address - Phone:973-493-4482
Mailing Address - Fax:
Practice Address - Street 1:235 W 22ND ST
Practice Address - Street 2:APT. 4W
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2744
Practice Address - Country:US
Practice Address - Phone:973-493-4482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY595494-1367500000X
COAPN.0996948-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered