Provider Demographics
NPI:1811181936
Name:KITCHEN, JADA W (FNP)
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:W
Last Name:KITCHEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JADA
Other - Middle Name:
Other - Last Name:DAWES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CFNP
Mailing Address - Street 1:424 WARDS CORNER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-6966
Mailing Address - Country:US
Mailing Address - Phone:513-707-4041
Mailing Address - Fax:513-576-1020
Practice Address - Street 1:312 HIGHLAND AVE STE H
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-1819
Practice Address - Country:US
Practice Address - Phone:740-335-8608
Practice Address - Fax:740-335-0137
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP0496 RN294932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2954398Medicaid
OHDANP34461Medicare PIN