Provider Demographics
NPI:1942030127
Name:ALHASSAN, TIFFANIE MARQUICA (CNA)
Entity type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:MARQUICA
Last Name:ALHASSAN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44301-2373
Mailing Address - Country:US
Mailing Address - Phone:330-809-7567
Mailing Address - Fax:
Practice Address - Street 1:449 PALM AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44301-2373
Practice Address - Country:US
Practice Address - Phone:330-809-7567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH324341160623376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide