Provider Demographics
NPI:1134844806
Name:CARPENTER-BAKER, TIFFANY ROSE
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ROSE
Last Name:CARPENTER-BAKER
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 1:406 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RITTMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44270-1145
Mailing Address - Country:US
Mailing Address - Phone:330-432-5174
Mailing Address - Fax:
Practice Address - Street 1:406 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RITTMAN
Practice Address - State:OH
Practice Address - Zip Code:44270-1145
Practice Address - Country:US
Practice Address - Phone:330-432-5174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion