Healthcare Provider Details

I. General information

NPI: 1972432144
Provider Name (Legal Business Name): MS. JETTA-JADE PINKELTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 TEXAS AVE
CINCINNATI OH
45205-1583
US

IV. Provider business mailing address

1217 TEXAS AVE
CINCINNATI OH
45205-1583
US

V. Phone/Fax

Practice location:
  • Phone: 937-609-9955
  • Fax: 937-609-9955
Mailing address:
  • Phone: 937-609-9955
  • Fax: 937-609-9955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: