Provider Demographics
NPI:1346758729
Name:COLVIN, JAIMEE KENYATTA
Entity Type:Individual
Prefix:
First Name:JAIMEE
Middle Name:KENYATTA
Last Name:COLVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAIMEE
Other - Middle Name:KENYATTA
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5082 GLENCROSSING WAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-3360
Mailing Address - Country:US
Mailing Address - Phone:513-978-1075
Mailing Address - Fax:513-978-1335
Practice Address - Street 1:5082 GLENCROSSING WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3360
Practice Address - Country:US
Practice Address - Phone:513-978-1075
Practice Address - Fax:513-978-1335
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily