Healthcare Provider Details

I. General information

NPI: 1811181936
Provider Name (Legal Business Name): JADA W. KITCHEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JADA DAWES CFNP

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 HIGHLAND AVE STE H
WASHINGTON COURT HOUSE OH
43160-1819
US

IV. Provider business mailing address

424 WARDS CORNER RD STE 200
LOVELAND OH
45140-6966
US

V. Phone/Fax

Practice location:
  • Phone: 740-335-8608
  • Fax: 740-335-0137
Mailing address:
  • Phone: 513-707-4041
  • Fax: 513-576-1020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP0496 RN294932
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: