Provider Demographics
NPI:1982856472
Name:TABOR-CURTIS, JENNIFER N (APRN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:N
Last Name:TABOR-CURTIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:N
Other - Last Name:TABOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:236 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1348
Mailing Address - Country:US
Mailing Address - Phone:859-404-7686
Mailing Address - Fax:859-274-4459
Practice Address - Street 1:209 N MAYSVILLE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1179
Practice Address - Country:US
Practice Address - Phone:859-404-7686
Practice Address - Fax:859-274-0785
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005761363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY11901364OtherCAQH
KY7100208300Medicaid
K043121OtherPTAN
KY7100208300Medicaid