Provider Demographics
NPI:1003320805
Name:MCDONALD, TIFFINI (RN)
Entity Type:Individual
Prefix:
First Name:TIFFINI
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7652 SAWMILL RD
Mailing Address - Street 2:139
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016
Mailing Address - Country:US
Mailing Address - Phone:614-589-9688
Mailing Address - Fax:
Practice Address - Street 1:8628 INDUSTRIAL PKWY STE E
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064-8069
Practice Address - Country:US
Practice Address - Phone:614-918-7476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH334302163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse