Healthcare Provider Details

I. General information

NPI: 1245623347
Provider Name (Legal Business Name): TIFFANY OWENS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIFFANY MCCLUNG RN

II. Dates (important events)

Enumeration Date: 03/13/2015
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 LOCKBOURNE RD
COLUMBUS OH
43206-3736
US

IV. Provider business mailing address

2620 ELM HILL PIKE
NASHVILLE TN
37214-3108
US

V. Phone/Fax

Practice location:
  • Phone: 614-930-1012
  • Fax: 614-413-2850
Mailing address:
  • Phone: 615-425-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.16710
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: