Provider Demographics
NPI:1912551086
Name:NESS, JESSICA (ATC, CFO)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:NESS
Suffix:
Gender:F
Credentials:ATC, CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 FOXGLOVE DR STE 7
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-9770
Mailing Address - Country:US
Mailing Address - Phone:859-498-1888
Mailing Address - Fax:859-498-1875
Practice Address - Street 1:250 FOXGLOVE DR STE 7
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9770
Practice Address - Country:US
Practice Address - Phone:859-498-1888
Practice Address - Fax:859-498-1875
Is Sole Proprietor?:No
Enumeration Date:2019-07-28
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT12392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer