Individual
DR. NANA YAA TACKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5825 BUFORD HWY STE 300, NORCROSS, GA 30071-2504
(770) 209-2787
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
106015
MN
207P00000X
Emergency Medicine Physician
Primary
69976
GA
207Q00000X
Family Medicine Physician
69976
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407114291
—
MN
Enumeration date
04/30/2012
Last updated
12/18/2024
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