Basic Information
Provider Information
NPI: 1366929960
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ORIANS
FirstName: MARY
MiddleName: GRIFFIN
NamePrefix:  
NameSuffix:  
Credential: APN, FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7714 POPLAR AVE STE 200
Address2:  
City: GERMANTOWN
State: TN
PostalCode: 381383941
CountryCode: US
TelephoneNumber: 9016830055
FaxNumber: 9016852969
Practice Location
Address1: 7945 WOLF RIVER BLVD
Address2:  
City: GERMANTOWN
State: TN
PostalCode: 381381762
CountryCode: US
TelephoneNumber: 9016830055
FaxNumber: 9016852969
Other Information
ProviderEnumerationDate: 07/26/2018
LastUpdateDate: 01/07/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/07/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X24213TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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