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Individual
TIFFANIE A HENDERSON
Active
Individual
TIFFANIE A HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, CNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.262930
OH
363LF0000X
Family Nurse Practitioner
Primary
COA12934NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0057309
—
OH
01
—
H052780
MEDICARE
OH
Enumeration date
11/03/2011
Last updated
11/03/2023
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