Provider Demographics
NPI:1366581647
Name:GRIFFITH, FAITH ANNETTE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:ANNETTE
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:A
Other - Last Name:GRIFFITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3200 MACCORKLE AVE SE FL 4
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1297
Mailing Address - Country:US
Mailing Address - Phone:304-388-8199
Mailing Address - Fax:304-388-8195
Practice Address - Street 1:3200 MACCORKLE AVE SE FL 4
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1297
Practice Address - Country:US
Practice Address - Phone:304-388-8199
Practice Address - Fax:304-388-8195
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV35364163WR0006X
OHAPRN.CNP.020785363LF0000X
WVAPRN35364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH02210015Medicaid
OH02210015Medicaid
OHH553350OtherMEDICARE - MHCPI