Individual
MISS DEANNA RAE TACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Mailing address
2163 W GLENALDEN DR, GERMANTOWN, TN 38139-5425
(901) 756-5198
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDN0000001656
TN
Other
Enumeration date
08/27/2006
Last updated
07/08/2007
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