Healthcare Provider Details

I. General information

NPI: 1144522475
Provider Name (Legal Business Name): JENNIFER LEE THOMAS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

8130 SHEED RD
CINCINNATI OH
45247-3527
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4200
  • Fax:
Mailing address:
  • Phone: 513-477-2268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN-250777
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP-11354
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: