Healthcare Provider Details

I. General information

NPI: 1043894876
Provider Name (Legal Business Name): PINKY JHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

3423 TOP FLITE LN
MASON OH
45040-4771
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8521
  • Fax: 513-475-7480
Mailing address:
  • Phone: 513-260-6951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0028852
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR.N.421853
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: