Provider Demographics
NPI:1487600730
Name:HAHN, JENNIE (MD)
Entity type:Individual
Prefix:
First Name:JENNIE
Middle Name:
Last Name:HAHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 HARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3000
Mailing Address - Country:US
Mailing Address - Phone:513-585-8227
Mailing Address - Fax:513-585-8278
Practice Address - Street 1:3131 HARVEY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3000
Practice Address - Country:US
Practice Address - Phone:513-585-8227
Practice Address - Fax:513-585-8278
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY365422084P0800X
OH35.0729472084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0256OtherMEDICARE
KY0256OtherMEDICARE