Individual
JASON STEVEN PENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
234 ALBERT SABIN WAY, ML 0769, CINCINNATI, OH 45267-2827
(513) 558-5281
(513) 558-5791
Mailing address
3200 BURNET AVE, 3 SOUTH, CENTRAL CREDENTIALING, CINCINNATI, OH 45229-3019
(513) 558-5281
(513) 558-5791
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.315551
OH
363L00000X
Nurse Practitioner
3012588
KY
363L00000X
Nurse Practitioner
433293
NY
363L00000X
Nurse Practitioner
COA.13491-NP
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.13491
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0071432
—
OH
05
—
7100301250
—
KY
Enumeration date
06/12/2012
Last updated
07/10/2025
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