Individual
JESSICA L CHEADLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C-NP
Contact information
Practice address
4777 E GALBRAITH RD STE 320, CINCINNATI, OH 45236-2725
(513) 751-2273
(513) 751-1848
Mailing address
5053 WOOSTER RD, CINCINNATI, OH 45226-2326
(513) 751-2273
(513) 751-1848
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
14047-NP
OH
363L00000X
Nurse Practitioner
71007486A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075334
—
OH
05
—
201132210
—
IN
05
—
7100160120
—
KY
Enumeration date
11/01/2012
Last updated
05/25/2023
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