Provider Demographics
NPI:1851081277
Name:WILLIAMS, TIFFANY ARMINTA
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ARMINTA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 FORTSTONE LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-3873
Mailing Address - Country:US
Mailing Address - Phone:614-571-8515
Mailing Address - Fax:
Practice Address - Street 1:1775 FORTSTONE LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-3873
Practice Address - Country:US
Practice Address - Phone:614-571-8515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide