Tiffany Penewit

Individual provider Active NPI Licensed Practical Nurse · Clarksville, OH

NPI 1487597282 · NPPES record last updated Apr 14, 2026

Key facts

NPI
1487597282
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LPN.144467.MEDS-IV (OH)
Practice address
2556 Lebanon Rd
Clarksville, OH 45113-8201
Phone
(937) 289-2109
Fax
(937) 744-4531
NPI assigned
Apr 14, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPN.144467.MEDS-IVOHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.144467.MEDS-IV OH Yes

Addresses

Primary practice location

2556 Lebanon Rd
Clarksville, OH 45113-8201

Mailing address

2717 Martinsville Rd
Martinsville, OH 45146-9704

Other providers in Clarksville, OH

All providers in Clarksville, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.