Healthcare Provider Details

I. General information

NPI: 1053780221
Provider Name (Legal Business Name): JODI YEE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2015
Last Update Date: 06/04/2020
Certification Date: 06/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 DUKE DR STE 220
MASON OH
45040-1553
US

IV. Provider business mailing address

7029 WALLACE AVE
CINCINNATI OH
45243-2618
US

V. Phone/Fax

Practice location:
  • Phone: 513-510-4406
  • Fax:
Mailing address:
  • Phone: 513-608-2107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.17281-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: