Healthcare Provider Details

I. General information

NPI: 1104164573
Provider Name (Legal Business Name): JASON CHRISTIAN JONES C.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2013
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 MAIN STREET
WILMINGTON OH
45177-0000
US

IV. Provider business mailing address

610 MAIN STREET
WILMINGTON OH
45177-0000
US

V. Phone/Fax

Practice location:
  • Phone: 513-865-2246
  • Fax: 513-865-5596
Mailing address:
  • Phone: 513-865-2246
  • Fax: 513-865-5596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA14235NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCOA-14235-NP
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.14235
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: