Individual
BILLIE L TACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
915 13TH AVE N, CLINTON, IA 52732-5067
(563) 246-2511
(563) 243-0817
Mailing address
915 13TH AVE N, CLINTON, IA 52732-5067
(563) 246-2511
(563) 243-0817
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F-067399
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0498519
—
IA
01
—
084118
HEALTH ALLIANCE
—
01
—
222235
IOWA HEALTH SOLUTIONS
—
01
—
240863
MIDLANDS CHOICE
—
01
—
35233
WELLMARK BC/BS
IA
01
—
IA01A8
JOHN DEERE HEALTH
—
Enumeration date
05/12/2006
Last updated
09/02/2014
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