Healthcare Provider Details

I. General information

NPI: 1982349197
Provider Name (Legal Business Name): TIFFANY ROXANNE STEELE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 05/17/2022
Certification Date: 05/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5169 BELLE ISLE DR
MORAINE OH
45439-3229
US

IV. Provider business mailing address

5169 BELLE ISLE DR
MORAINE OH
45439-3229
US

V. Phone/Fax

Practice location:
  • Phone: 937-718-8222
  • Fax:
Mailing address:
  • Phone: 937-718-8222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: