Provider Demographics
NPI:1114649282
Name:HAHN, TIFFANEE JO
Entity type:Individual
Prefix:
First Name:TIFFANEE
Middle Name:JO
Last Name:HAHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 FOWLERS LN
Mailing Address - Street 2:
Mailing Address - City:NEW LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43764-9779
Mailing Address - Country:US
Mailing Address - Phone:740-319-9044
Mailing Address - Fax:
Practice Address - Street 1:315 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:OH
Practice Address - Zip Code:43783-9790
Practice Address - Country:US
Practice Address - Phone:740-319-9044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide