Provider Demographics
NPI:1982211595
Name:BARNETT, JESSICA LYNNE (APRN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNNE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNNE
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6949 GOOD SAMARITAN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-5204
Mailing Address - Country:US
Mailing Address - Phone:513-853-1300
Mailing Address - Fax:
Practice Address - Street 1:3035 HAMILTON MASON RD STE 204
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-5545
Practice Address - Country:US
Practice Address - Phone:513-853-1300
Practice Address - Fax:513-451-1356
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0027471363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2565399Medicaid