Provider Demographics
NPI:1174050801
Name:CARTY, JESSICA N (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:N
Last Name:CARTY
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 1:6 LINVILLE DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2128
Mailing Address - Country:US
Mailing Address - Phone:859-987-3710
Mailing Address - Fax:859-335-3266
Practice Address - Street 1:6 LINVILLE DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2128
Practice Address - Country:US
Practice Address - Phone:859-987-3710
Practice Address - Fax:859-335-3266
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011289363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner