Healthcare Provider Details

I. General information

NPI: 1366261935
Provider Name (Legal Business Name): JOIE TEJADA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 MACK RD STE 200
FAIRFIELD OH
45014-5300
US

IV. Provider business mailing address

6211 MILLSTONE CT
MILFORD OH
45150-2244
US

V. Phone/Fax

Practice location:
  • Phone: 513-829-1700
  • Fax: 513-829-5333
Mailing address:
  • Phone: 513-658-8435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0037234
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: