Provider Demographics
NPI:1124418157
Name:DUNBAR, TIFFANY L (CNP)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:L
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:L
Other - Last Name:BILINOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:664 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3906
Mailing Address - Country:US
Mailing Address - Phone:740-652-4177
Mailing Address - Fax:407-854-9427
Practice Address - Street 1:664 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3906
Practice Address - Country:US
Practice Address - Phone:740-652-4177
Practice Address - Fax:740-785-4942
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.17049363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0118423Medicaid
OHH324390Medicare PIN