Individual
MRS. TIFFANI LYNETTE DORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
919 GLYN EVANS CT, NEWARK, OH 43055-1792
(740) 405-5120
(740) 788-8268
Mailing address
919 GLYN EVANS CT, NEWARK, OH 43055-1792
(740) 405-5120
(740) 788-8268
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004253
OH
363A00000X
Physician Assistant
027353
NY
363A00000X
Physician Assistant
085.008370
IL
363A00000X
Physician Assistant
7562-23
WI
363A00000X
Physician Assistant
OA006586
PA
Other
Enumeration date
02/20/2015
Last updated
04/17/2024
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