Healthcare Provider Details

I. General information

NPI: 1073195434
Provider Name (Legal Business Name): JASMINE OLIVIA PRINCE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 W 10TH AVE
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-2957
  • Fax: 614-688-3700
Mailing address:
  • Phone: 614-293-2957
  • Fax: 614-688-3700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number35.150746
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: