Individual
TONI T TACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
450 W LOCKE ST, ASHDOWN, AR 71822-3326
(870) 898-1400
Mailing address
450 W LOCKE ST STE C, ASHDOWN, AR 71822-3326
(870) 898-4100
(870) 898-4136
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A003233
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196496758
—
AR
Enumeration date
12/18/2009
Last updated
01/11/2022
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