Healthcare Provider Details

I. General information

NPI: 1255296596
Provider Name (Legal Business Name): JASMINE CORINE HAMPTON B.S TCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 CUMBERLAND FALLS HWY
CORBIN KY
40701-2735
US

IV. Provider business mailing address

394 HANES BAKER RD
CORBIN KY
40701-4903
US

V. Phone/Fax

Practice location:
  • Phone: 606-389-3903
  • Fax:
Mailing address:
  • Phone: 606-309-8847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: