Individual
MARIA TACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
214 BERIAH BLVD, SALYERSVILLE, KY 41465-7509
(606) 349-5126
(606) 349-5123
Mailing address
1709 KY ROUTE 321, PRESTONSBURG, KY 41653-9097
(606) 886-8546
(606) 886-8548
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4022810
KY
Other
Enumeration date
06/10/2024
Last updated
09/13/2024
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