TIFFANY MCKENNON NPI 1720509755

NPI Information

Tiffany Mckennon is a home health aide in Jacksonville, FL. The provider is a person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. Tiffany Mckennon NPI is 1720509755. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

11039 COLONIAL TAVERN LN
JACKSONVILLE, FL
ZIP 32221-123
Phone: (904) 450-1430

The CLIA number assigned to this NPI record is 10D2254281 - mobile lab with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/29/2017 and was last updated on 11/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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