MEDICARE: TIFFANY S JOHNSON

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.022545	OH
2	363LF0000X	Family Nurse Practitioner	APRN.CNP.022545	OH

General Provider Information

NPI Number	:	1285145342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY S JOHNSON

Provider Business Mailing Address
First Line	:	3350 CLEVELAND AVE STE 1964
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-3677
Country	:	US
Telephone Number	:	614-523-2929
Fax Number	:	614-523-3388

Provider Business Practice Location Address
First Line	:	3350 CLEVELAND AVE STE 1964
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-3677
Country	:	US
Telephone Number	:	614-523-2929
Fax Number	:	614-523-3388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2017
Last Update Date	:	03/16/2026

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Directions to “ TIFFANY S JOHNSON ” Practice Location

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