Individual
MS. TIFFANI ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4580 COMMONS PARK DR, NEW ALBANY, OH 43054-8699
(614) 710-0077
(614) 710-0077
Mailing address
4580 COMMONS PARK DR, NEW ALBANY, OH 43054-8699
(614) 710-0727
(614) 710-0077
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN267314
OH
363LP2300X
Primary Care Nurse Practitioner
Primary
COA.17574-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0088547
—
OH
Enumeration date
01/28/2013
Last updated
11/12/2019
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