Healthcare Provider Details

I. General information

NPI: 1205000262
Provider Name (Legal Business Name): TIFFANIE R KEHRT MSN, RN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2008
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MACK RD FL 3
FAIRFIELD OH
45014-5335
US

IV. Provider business mailing address

10306 FAY LN
CINCINNATI OH
45251-1182
US

V. Phone/Fax

Practice location:
  • Phone: 513-774-2870
  • Fax: 513-774-2727
Mailing address:
  • Phone: 513-240-8775
  • Fax: 910-408-0454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number09948
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: