Individual
KALEIGH TACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4566 S EASON BLVD, TUPELO, MS 38801-6540
(662) 322-8750
Mailing address
4566 S EASON BLVD, TUPELO, MS 38801-6540
(662) 322-8750
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
910052
MS
Other
Enumeration date
12/03/2021
Last updated
12/03/2021
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