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General NPI Number Information
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NPI Number | 1205519188
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Entity Type | Individual
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Provider Name | TIFFANY MARIE THOMPSON APRN
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Gender | Female
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 1350 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44483-6608
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Country | US
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Telephone | 330-841-9729
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Fax |
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Provider Business Mailing Address
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Address Line | 6480 ROCKSIDE WOODS BLVD S STE 330
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2222
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0033857
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License Number State | OH
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