MEDICARE: TIFFANIE MARQUICA ALHASSAN CNA

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	376K00000X	Nurse's Aide	324341160623	OH

General Provider Information

NPI Number	:	1942030127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANIE MARQUICA ALHASSAN CNA

Provider Business Mailing Address
First Line	:	449 PALM AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44301-2373
Country	:	US
Telephone Number	:	330-809-7567
Fax Number	:

Provider Business Practice Location Address
First Line	:	449 PALM AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44301-2373
Country	:	US
Telephone Number	:	330-809-7567
Fax Number	:

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

Provider Enumeration Date	:	08/03/2024
Last Update Date	:	08/03/2024

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