Provider Demographics
NPI:1386177095
Name:ROBINSON, TIFFANY RENEE
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:RENEE
Last Name:ROBINSON
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 1:16409 CLEARVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-3711
Mailing Address - Country:US
Mailing Address - Phone:216-632-7172
Mailing Address - Fax:
Practice Address - Street 1:16409 CLEARVIEW AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-3711
Practice Address - Country:US
Practice Address - Phone:216-632-7172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide