Provider Demographics
NPI:1871873216
Name:LOHR, TIFFANY ANNE (LPN)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:ANNE
Last Name:LOHR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6361 COUNTY ROAD 37
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44904-9693
Mailing Address - Country:US
Mailing Address - Phone:419-631-8131
Mailing Address - Fax:
Practice Address - Street 1:6361 COUNTY ROAD 37
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44904-9693
Practice Address - Country:US
Practice Address - Phone:419-631-8131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 128205164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3008622Medicaid