Healthcare Provider Details

I. General information

NPI: 1699639468
Provider Name (Legal Business Name): TIFFANY LYNN MORRIS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5594 STATE ROUTE 7
ANDOVER OH
44003-9490
US

IV. Provider business mailing address

2392 CLEARVIEW AVE NW
WARREN OH
44483-1338
US

V. Phone/Fax

Practice location:
  • Phone: 440-293-2444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0039880
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: