Healthcare Provider Details

I. General information

NPI: 1356876940
Provider Name (Legal Business Name): JENNIFER VADEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 SMITH RD STE 250
CINCINNATI OH
45212-2733
US

IV. Provider business mailing address

2704 WESLEY DR
VILLA HILLS KY
41017-1041
US

V. Phone/Fax

Practice location:
  • Phone: 513-699-9090
  • Fax:
Mailing address:
  • Phone: 859-750-3080
  • Fax: 210-899-1849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number021655
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3011444
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1131377
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: