Healthcare Provider Details

I. General information

NPI: 1598577603
Provider Name (Legal Business Name): JENNA NICOLE BERNHARDT PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 S 5TH ST
COLUMBUS OH
43215-4325
US

IV. Provider business mailing address

81 S 5TH ST
COLUMBUS OH
43215-4325
US

V. Phone/Fax

Practice location:
  • Phone: 419-722-5883
  • Fax: 317-643-3499
Mailing address:
  • Phone: 419-722-5883
  • Fax: 317-643-3499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0038528
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71016693A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71016693A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0038528
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: