Healthcare Provider Details

I. General information

NPI: 1295652782
Provider Name (Legal Business Name): JESSICA MARIE WHITE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 YANKEE RD
LIBERTY TOWNSHIP OH
45044-3500
US

IV. Provider business mailing address

9884 MONTCLAIRE DR
MASON OH
45040-9532
US

V. Phone/Fax

Practice location:
  • Phone: 513-803-9600
  • Fax:
Mailing address:
  • Phone: 513-739-0425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0042338
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: