Provider Demographics
NPI:1891003737
Name:NEW CONCEPTS, II LLC
Entity Type:Organization
Organization Name:NEW CONCEPTS, II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANECIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:513-607-5524
Mailing Address - Street 1:6283 ZOELLNERS PL
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45011-1001
Mailing Address - Country:US
Mailing Address - Phone:513-607-5524
Mailing Address - Fax:
Practice Address - Street 1:791 E MCMILLAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1910
Practice Address - Country:US
Practice Address - Phone:513-751-2221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA09517-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty