Provider Demographics
NPI:1184981870
Name:PERKINS, TIFFINNE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:TIFFINNE
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:TIFFINNE
Other - Middle Name:
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, CNP
Mailing Address - Street 1:1408 S GREEN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3920
Mailing Address - Country:US
Mailing Address - Phone:440-409-2023
Mailing Address - Fax:
Practice Address - Street 1:16808 CHAGRIN BLVD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120-3724
Practice Address - Country:US
Practice Address - Phone:440-409-2023
Practice Address - Fax:216-415-6858
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN331153163W00000X
OH0031476363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse