Provider Demographics
NPI:1982349197
Name:STEELE, TIFFANY ROXANNE
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ROXANNE
Last Name:STEELE
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 1:5169 BELLE ISLE DR
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-3229
Mailing Address - Country:US
Mailing Address - Phone:937-718-8222
Mailing Address - Fax:
Practice Address - Street 1:5169 BELLE ISLE DR
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-3229
Practice Address - Country:US
Practice Address - Phone:937-718-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 376J00000X
OH3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No172A00000XOther Service ProvidersDriver
No376J00000XNursing Service Related ProvidersHomemaker