| NPI | 1881041796 |
|---|---|
| Former Name | TIFFANY RENEE PREDRAGOVICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN.127157-M-IV) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.127157.MEDS-IV) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2023-11-07 |