Provider Demographics
NPI:1619590148
Name:TUFF, RICHARD (CNP)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:TUFF
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 CENTERVILLE BUSINESS PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2691
Mailing Address - Country:US
Mailing Address - Phone:937-637-6735
Mailing Address - Fax:937-963-0961
Practice Address - Street 1:6601 CENTERVILLE BUSINESS PKWY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-2691
Practice Address - Country:US
Practice Address - Phone:963-637-6735
Practice Address - Fax:937-963-0961
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-19
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH442385163WP0808X
OH29228363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health