Provider Demographics
NPI:1598414864
Name:DUPKE, TIFFANY N (APRN-CNP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:N
Last Name:DUPKE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:740-845-7500
Mailing Address - Fax:740-845-7501
Practice Address - Street 1:55 PARK AVE STE 275
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-1294
Practice Address - Country:US
Practice Address - Phone:740-845-7500
Practice Address - Fax:740-845-7501
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028613363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily