Healthcare Provider Details

I. General information

NPI: 1447201504
Provider Name (Legal Business Name): JOLA FAWN HATFIELD RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4831 BEECHWOOD FARMS DR
CINCINNATI OH
45244
US

IV. Provider business mailing address

4831 BEECHWOOD FARMS DR
CINCINNATI OH
45244
US

V. Phone/Fax

Practice location:
  • Phone: 513-528-7188
  • Fax: 513-528-7188
Mailing address:
  • Phone: 513-528-7188
  • Fax: 513-528-7188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number194571
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number194571
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: