Provider Demographics
NPI:1619100724
Name:JONES, TIFFANY DENISE
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:DENISE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:TIFFANY
Other - Middle Name:DENISE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:15218 STEINWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-4621
Mailing Address - Country:US
Mailing Address - Phone:216-255-4536
Mailing Address - Fax:
Practice Address - Street 1:15218 STEINWAY BLVD
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-4621
Practice Address - Country:US
Practice Address - Phone:216-255-4536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN134792164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse