Provider Demographics
NPI:1780355503
Name:HACKER, GINGER (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:HACKER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9117 CINCINNATI COLUMBUS RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-3701
Mailing Address - Country:US
Mailing Address - Phone:513-229-7585
Mailing Address - Fax:513-672-0792
Practice Address - Street 1:9117 CINCINNATI COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-3701
Practice Address - Country:US
Practice Address - Phone:513-229-7585
Practice Address - Fax:513-672-0792
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0031189363LP0808X
OH398405163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse