Healthcare Provider Details

I. General information

NPI: 1306335294
Provider Name (Legal Business Name): JENNIFER LEQUIEU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2018
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 STEFFEN AVE
CINCINNATI OH
45215-2338
US

IV. Provider business mailing address

1401 STEFFEN AVE
CINCINNATI OH
45215-2338
US

V. Phone/Fax

Practice location:
  • Phone: 513-554-4100
  • Fax:
Mailing address:
  • Phone: 513-554-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.164744
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036.164744
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: