Healthcare Provider Details
I. General information
NPI: 1083098628
Provider Name (Legal Business Name): JESSICA LYNN HENDRIX AGAC-NP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/14/2015
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2139 AUBURN AVE INPATIENT CARDIOLOGY
CINCINNATI OH
45219
US
IV. Provider business mailing address
2139 AUBURN AVE # 4-7
CINCINNATI OH
45219-2906
US
V. Phone/Fax
- Phone: 513-585-2000
- Fax: 513-206-1182
- Phone: 513-263-9703
- Fax: 513-830-9185
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 3009557 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | CNP.020276 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: