Healthcare Provider Details

I. General information

NPI: 1568134229
Provider Name (Legal Business Name): JODY HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 02/08/2022
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3760 PAXTON AVE
CINCINNATI OH
45209-2306
US

IV. Provider business mailing address

3760 PAXTON AVE
CINCINNATI OH
45209-2306
US

V. Phone/Fax

Practice location:
  • Phone: 513-488-8077
  • Fax:
Mailing address:
  • Phone: 513-488-8077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLE00037578
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0030306
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: