Provider Demographics
NPI:1659700136
Name:JONES, TIFFANY N (ACNP)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:N
Last Name:JONES
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:MRS
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:MOYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5053 WOOSTER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-2326
Mailing Address - Country:US
Mailing Address - Phone:513-751-2145
Mailing Address - Fax:513-751-2138
Practice Address - Street 1:4350 MALSBARY RD
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-5665
Practice Address - Country:US
Practice Address - Phone:513-751-2273
Practice Address - Fax:513-792-5850
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15359-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0112174Medicaid
OH0112174Medicaid