Healthcare Provider Details

I. General information

NPI: 1427995497
Provider Name (Legal Business Name): MIA M TIPPLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3984 STATE ROUTE 257 S
OSTRANDER OH
43061-9443
US

IV. Provider business mailing address

3984 STATE ROUTE 257 S
OSTRANDER OH
43061-9443
US

V. Phone/Fax

Practice location:
  • Phone: 937-209-9510
  • Fax:
Mailing address:
  • Phone: 937-209-9510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: