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General NPI Number Information
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NPI Number | 1225747488
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Entity Type | Organization
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Legal Business Name | TEAM JESUS MOST HOPE LLC
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 3515 SIARON WAY LOWR LEVEL
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City | HAMILTON
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State | OH
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Zip | 45011-2684
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Country | US
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Telephone | 513-795-6972
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Fax | 513-902-8765
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Provider Business Mailing Address
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Address Line | 3515 SIARON WAY LOWR LEVEL
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City | HAMILTON
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State | OH
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Zip | 45011-2684
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Country | US
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Telephone | 513-795-6972
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Fax | 513-902-8765
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Authorized Official
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Title or Position | ADDICTION NURSE PRACTITIONER/OWNER
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Name | KESHIA NICHOLE JORDAN
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Credential | APRN-CNP
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Telephone | 513-795-6972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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