Provider Demographics
NPI:1053644831
Name:COLVIN-JACKSON, SHERI PATRICE (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:PATRICE
Last Name:COLVIN-JACKSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 READING RD STE B
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-3203
Mailing Address - Country:US
Mailing Address - Phone:513-653-0281
Mailing Address - Fax:513-653-0098
Practice Address - Street 1:7601 READING RD STE B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-3203
Practice Address - Country:US
Practice Address - Phone:513-653-0281
Practice Address - Fax:513-653-0098
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH287003163W00000X
OHAPRN.CNP.0034201261QP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care