Provider Demographics
NPI:1174572879
Name:GRIFFIN, DEBRA S (CRNA)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:S
Last Name:GRIFFIN
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 1:190 N UNION ST
Mailing Address - Street 2:STE 104
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1369
Mailing Address - Country:US
Mailing Address - Phone:330-253-9145
Mailing Address - Fax:330-253-6222
Practice Address - Street 1:190 N UNION ST
Practice Address - Street 2:STE 104
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1369
Practice Address - Country:US
Practice Address - Phone:330-253-9145
Practice Address - Fax:330-253-6222
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-206799367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH100153OtherEMPLYER KAISER GROUP #
OH122298OtherKAISER PERMANENTE INDV #
OH000000380806OtherANTHEM BCBS INDV NUMBER
OH2080224OtherUNITED HEALTHCARE GROUP #
OH2606577Medicaid
OH7091249Medicaid
OHCN1092Medicare ID - Type UnspecifiedEMPLYR RR MEDICARE GRP #
OHGR8236141Medicare ID - Type UnspecifiedMEDICARE INDV NUMBER
OH2606577Medicaid