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Individual

MRS. YIM LEI TACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
7362 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4773
(901) 271-1000
(901) 271-4187
Mailing address
8060 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1727
(901) 271-1000
(901) 271-4187

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
21444
TN
363LF0000X
Family Nurse Practitioner
Primary
901733
MS

Other

Enumeration date
06/09/2016
Last updated
04/26/2018
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