Provider Demographics
NPI:1396560561
Name:GRANT, TIFFANY N (CNA)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:N
Last Name:GRANT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6051 GLENWAY DR APT B
Mailing Address - Street 2:
Mailing Address - City:BROOKPARK
Mailing Address - State:OH
Mailing Address - Zip Code:44142-1457
Mailing Address - Country:US
Mailing Address - Phone:216-543-9774
Mailing Address - Fax:
Practice Address - Street 1:6051 GLENWAY DR APT B
Practice Address - Street 2:
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-1457
Practice Address - Country:US
Practice Address - Phone:216-543-9774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide