Healthcare Provider Details

I. General information

NPI: 1578219986
Provider Name (Legal Business Name): JENNIFER RENEIE BAKER PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8170 CORPORATE PARK DR STE 150
CINCINNATI OH
45242-3300
US

IV. Provider business mailing address

3400 OAK SPRING DR
FAIRFIELD TOWNSHIP OH
45011-7115
US

V. Phone/Fax

Practice location:
  • Phone: 614-368-1357
  • Fax:
Mailing address:
  • Phone: 937-604-1076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0030787
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: