Healthcare Provider Details

I. General information

NPI: 1487600730
Provider Name (Legal Business Name): JENNIE HAHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 02/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 HARVEY AVE
CINCINNATI OH
45229-3000
US

IV. Provider business mailing address

3131 HARVEY AVE
CINCINNATI OH
45229-3000
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-8227
  • Fax: 513-585-8278
Mailing address:
  • Phone: 513-585-8227
  • Fax: 513-585-8278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number36542
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number35.072947
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: