Individual
TIFFANY DIANE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
1406 E 82ND ST, CLEVELAND, OH 44103-2944
(440) 650-9158
Mailing address
1406 E 82ND ST, CLEVELAND, OH 44103-2944
(440) 482-6220
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457751729
—
OH
Enumeration date
08/24/2014
Last updated
10/09/2021
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