Healthcare Provider Details

I. General information

NPI: 1801699855
Provider Name (Legal Business Name): JABRINA SIMMONS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 PIEDMONT AVE
CINCINNATI OH
45219-4231
US

IV. Provider business mailing address

12111 DETROIT AVE
LAKEWOOD OH
44107-3018
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8787
  • Fax:
Mailing address:
  • Phone: 937-414-0598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: