Provider Demographics
NPI:1821538000
Name:FOUST, TIFFANY MARIE (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:FOUST
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 YOUNGSTOWN KINGSVILLE RD SE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44473-9601
Mailing Address - Country:US
Mailing Address - Phone:330-394-2305
Mailing Address - Fax:330-394-1405
Practice Address - Street 1:341 YOUNGSTOWN KINGSVILLE RD SE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:OH
Practice Address - Zip Code:44473-9601
Practice Address - Country:US
Practice Address - Phone:330-394-2305
Practice Address - Fax:330-394-1405
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020138363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0209382Medicaid