Provider Demographics
NPI:1841034006
Name:CHALUT, TIFFANY K
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:K
Last Name:CHALUT
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 1:4917 MCCURDY RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44864-9679
Mailing Address - Country:US
Mailing Address - Phone:419-561-7129
Mailing Address - Fax:
Practice Address - Street 1:4917 MCCURDY RD
Practice Address - Street 2:
Practice Address - City:PERRYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44864-9679
Practice Address - Country:US
Practice Address - Phone:419-561-7129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-22
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant