Individual
JESSICA MARIE SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
11500 NORTHLAKE DR, CINCINNATI, OH 45249-1650
(513) 742-6310
Mailing address
6557 STONELAKE WAY, FAIRFIELD TOWNSHIP, OH 45011-8160
(513) 828-1578
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71008628A
IN
363LF0000X
Family Nurse Practitioner
71008628A
IN
363LG0600X
Gerontology Nurse Practitioner
CNP.020779
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN.CNP.020779
LICENSE
OH
Enumeration date
12/19/2018
Last updated
03/12/2023
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