Individual
MRS. TIFFANI SANDRA BARTOLAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
711 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3439
(859) 287-3045
(859) 578-3800
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 426-0800
(859) 426-4140
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3012078
KY
363LF0000X
Family Nurse Practitioner
APRN CNP 019769
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184607
MEDICARE GROUP NUMBER
KY
Enumeration date
06/30/2006
Last updated
12/19/2025
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