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Individual

JONATHAN M EARL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 584-7372
(513) 584-2605
Mailing address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 584-7372
(513) 584-2605

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
COA.16230-NP
OH
363LG0600X
Gerontology Nurse Practitioner
COA.16230-NP
OH
363LP2300X
Primary Care Nurse Practitioner
COA.16230-NP
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0114203
OH
01
12753046
CAQH
01
4176914
AETNA
OH
01
QMP000004814954
MOLINA
OH
Enumeration date
10/08/2014
Last updated
03/26/2020
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