Healthcare Provider Details

I. General information

NPI: 1821772575
Provider Name (Legal Business Name): TIFFANY NICOLE WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

446 MORGAN ST
CINCINNATI OH
45206-2348
US

IV. Provider business mailing address

2788 WESTBROOK DR
CINCINNATI OH
45211-7615
US

V. Phone/Fax

Practice location:
  • Phone: 833-510-4357
  • Fax:
Mailing address:
  • Phone: 513-406-7009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.185403
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: