Healthcare Provider Details

I. General information

NPI: 1710853924
Provider Name (Legal Business Name): JESSICA LYNN KLINGERMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

4685 FOREST AVE
CINCINNATI OH
45212-3397
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7000
  • Fax: 513-246-7505
Mailing address:
  • Phone: 513-246-7000
  • Fax: 513-246-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0040560
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: