Healthcare Provider Details

I. General information

NPI: 1417572017
Provider Name (Legal Business Name): TIFFANY SWAIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6520 HAYDEN RUN RD UNIT 2
HILLIARD OH
43026-3439
US

IV. Provider business mailing address

4070 SCHIRTZINGER RD
HILLIARD OH
43026-2537
US

V. Phone/Fax

Practice location:
  • Phone: 614-638-7857
  • Fax: 614-756-4836
Mailing address:
  • Phone: 614-638-7857
  • Fax: 614-756-4836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberAPRN.CNP.0026817
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: