Healthcare Provider Details
I. General information
NPI: 1477051522
Provider Name (Legal Business Name): TIFFANY ALYSE RIEPENHOFF NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/24/2018
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3333 BURNET AVE ML 7017
CINCINNATI OH
45229
US
IV. Provider business mailing address
3333 BURNET AVE ML 7017
CINCINNATI OH
45229-3026
US
V. Phone/Fax
- Phone: 513-636-4578
- Fax: 513-636-7039
- Phone: 513-636-4578
- Fax: 513-636-7039
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | APRN.CNP.021568 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | APRN.CNP.021568 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: