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NPI Code Detail

MEDICARE: JESSICA CRUTCHLEO

MEDICARE: JESSICA CRUTCHLEO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1679404826
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA CRUTCHLEO
Provider Business Mailing Address
First Line : 615 ELSINORE PL STE 500
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1455
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 615 ELSINORE PL STE 500
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1455
Country : US
Telephone Number : 513-231-6630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2026
Last Update Date : 05/27/2026

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Directions to “ JESSICA CRUTCHLEO ” Practice Location

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