Provider Demographics
NPI:1205000262
Name:KEHRT, TIFFANIE R (MSN, RN, CNP)
Entity type:Individual
Prefix:MRS
First Name:TIFFANIE
Middle Name:R
Last Name:KEHRT
Suffix:
Gender:F
Credentials:MSN, RN, CNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10306 FAY LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-1182
Mailing Address - Country:US
Mailing Address - Phone:513-240-8775
Mailing Address - Fax:910-408-0454
Practice Address - Street 1:3000 MACK RD
Practice Address - Street 2:FL 3
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5335
Practice Address - Country:US
Practice Address - Phone:513-774-2870
Practice Address - Fax:513-774-2727
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH09948363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3007310Medicaid
OHH238090Medicare PIN