Healthcare Provider Details

I. General information

NPI: 1346758729
Provider Name (Legal Business Name): JAIMEE KENYATTA COLVIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAIMEE KENYATTA FIELDS

II. Dates (important events)

Enumeration Date: 01/19/2018
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5082 GLENCROSSING WAY
CINCINNATI OH
45238-3360
US

IV. Provider business mailing address

5082 GLENCROSSING WAY
CINCINNATI OH
45238-3360
US

V. Phone/Fax

Practice location:
  • Phone: 513-978-1075
  • Fax: 513-978-1335
Mailing address:
  • Phone: 513-978-1075
  • Fax: 513-978-1335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022101
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN.319543
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: