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NPI Code Detail

MEDICARE: MISS TIFFANY NICOLE PONTIOUS

MEDICARE: MISS TIFFANY NICOLE PONTIOUS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083321293
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TIFFANY NICOLE PONTIOUS
Provider Business Mailing Address
First Line : 8308 OHIO RIVER RD
Second Line :
City : WHEELERSBURG
State : OH
Zip : 45694-1714
Country : US
Telephone Number : 740-529-1201
Fax Number :
Provider Business Practice Location Address
First Line : 8308 OHIO RIVER RD
Second Line :
City : WHEELERSBURG
State : OH
Zip : 45694-1714
Country : US
Telephone Number : 740-529-1201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2022
Last Update Date : 10/28/2022

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1316654510 — MR. JASON LEWIS HAMMOND
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1821705013 — MRS. BEVERLY FAYE VAUGHN-TRAVIS
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1730896945 — MISS TISHA NICOLE DELABAR
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WHEELERSBURG, OH
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Directions to “ MISS TIFFANY NICOLE PONTIOUS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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