Individual
TARA L. TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
400 COURT ST STE 100, CHARLESTON, WV 25301
(304) 347-6120
(304) 347-6142
Mailing address
400 COURT ST STE 100, CHARLESTON, WV 25301-1652
(304) 347-6120
(304) 347-6126
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN63856-NP-C
WV
363LF0000X
Family Nurse Practitioner
63856
WV
363LF0000X
Family Nurse Practitioner
Primary
APRN63856-NP-C
WV
Other
Enumeration date
05/11/2016
Last updated
09/22/2025
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