Active NPI
Jessica Nicole Tanner, PHARMD
- Pharmacist
- Corbin, KY
National Provider Identifier
1497563696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 021662
- Practice address
- 14949 N US Highway 25 E
Corbin, KY 40701-6285 - Phone
- (606) 280-4212
- NPI assigned
- Dec 20, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 021662 | KY | Primary |
Addresses
Primary practice location
14949 N US Highway 25 E
Corbin, KY 40701-6285
Mailing address
PO Box 4007
Mount Vernon, KY 40456-4007
Phone (606) 308-3859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021662 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734652800000",
"number": "1497563696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4007",
"city": "MOUNT VERNON",
"state": "KY",
"postal_code": "404564007",
"telephone_number": "606-308-3859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14949 N US HIGHWAY 25 E",
"city": "CORBIN",
"state": "KY",
"postal_code": "407016285",
"telephone_number": "606-280-4212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNER",
"first_name": "JESSICA",
"middle_name": "NICOLE",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-12-20",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "021662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corbin, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.