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NPI Code Detail

MEDICARE: MRS. TIFFANY L EVANS

MEDICARE:  MRS. TIFFANY L EVANS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172A00000XDriver
2251X00000XSupports Brokerage Agency
3376J00000XHomemaker
4253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1689450967
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY L EVANS
Provider Business Mailing Address
First Line : 3526 ZINSLE AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45213-1856
Country : US
Telephone Number : 513-518-0776
Fax Number :
Provider Business Practice Location Address
First Line : 3526 ZINSLE AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45213-1856
Country : US
Telephone Number : 513-518-0776
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2023
Last Update Date : 09/04/2023

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Directions to “ MRS. TIFFANY L EVANS ” Practice Location

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