Provider Demographics
NPI:1639674518
Name:HSIAO, JESSICA (RN)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:HSIAO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3662 STONEBRIDGE DR APT F
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-5144
Mailing Address - Country:US
Mailing Address - Phone:978-886-9608
Mailing Address - Fax:
Practice Address - Street 1:260 STETSON ST STE 2300
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2450
Practice Address - Country:US
Practice Address - Phone:513-558-0128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-24
Last Update Date:2019-09-03
Deactivation Date:2019-08-16
Deactivation Code:
Reactivation Date:2019-08-29
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025068363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner