Provider Demographics
NPI:1962911925
Name:JETER, LA'RISHA RONA'E (APRN)
Entity type:Individual
Prefix:
First Name:LA'RISHA
Middle Name:RONA'E
Last Name:JETER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 ELM ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-7991
Mailing Address - Country:US
Mailing Address - Phone:513-531-1980
Mailing Address - Fax:513-351-0720
Practice Address - Street 1:1704 ELM ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-7991
Practice Address - Country:US
Practice Address - Phone:513-531-1980
Practice Address - Fax:513-351-0720
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027777363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty