Healthcare Provider Details

I. General information

NPI: 1255737698
Provider Name (Legal Business Name): TIFFANIE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TIFFANIE JONES MS, AT

II. Dates (important events)

Enumeration Date: 11/12/2014
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 CLARK ST
CAMBRIDGE OH
43725-9614
US

IV. Provider business mailing address

3865 WESLEY CHAPEL RD
ZANESVILLE OH
43701-9334
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT. 003847
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: