Healthcare Provider Details

I. General information

NPI: 1972411635
Provider Name (Legal Business Name): JENNIFER WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E HIGH ST
OXFORD OH
45056-1846
US

IV. Provider business mailing address

5474 HEADGATES RD
FAIRFIELD TOWNSHIP OH
45011-2045
US

V. Phone/Fax

Practice location:
  • Phone: 513-529-1809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0042778
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: