Healthcare Provider Details

I. General information

NPI: 1215868591
Provider Name (Legal Business Name): JADA CORNIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1471 LARANN LN
CINCINNATI OH
45231-5315
US

IV. Provider business mailing address

1920 CONNECTICUT AVE APT 2
CINCINNATI OH
45224-2396
US

V. Phone/Fax

Practice location:
  • Phone: 513-816-3217
  • Fax:
Mailing address:
  • Phone: 513-816-3217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: