Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacob Farley Tanner, MS, ATC, LAT

Individual provider Athletic Trainer · NPI 1871016105

Jacob Farley Tanner, MS, ATC, LAT is an Athletic Trainer in Creve Coeur, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2017
What do these letters mean?
MS — Master of Science
A graduate science degree.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

1054 Town And Four Parkway Dr
Creve Coeur, MO 63141
Phone: (314) 803-7792
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2015026272 (MO)

Record details

NPI number1871016105
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , ATC , LAT
Sole proprietorYes
NPI enumeratedJuly 19, 2017
Last updated in NPPESAugust 3, 2017

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