Jessica Tabor

Individual provider Active NPI Registered Nurse · South Shore, KY

NPI 1659299261 · NPPES record last updated Jul 9, 2026

Key facts

NPI
1659299261
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN.552205 (OH)
Practice address
500 Main St
South Shore, KY 41175-9560
Phone
(740) 876-2864
NPI assigned
Jul 9, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse
Group: 193200000X MULTI-SPECIALTY GROUP
163W00000X RN.552205 OH Yes

Addresses

Primary practice location

500 Main St
South Shore, KY 41175-9560

Mailing address

500 Main St
South Shore, KY 41175-9560

Other providers in South Shore, KY

All providers in South Shore, KY · Registered Nurse in Kentucky

Sources for this page

Verify at the official NPI Registry.