Individual
JACK TAGGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-6514
(352) 273-8610
Mailing address
3320 TATES CREEK RD, SUITE 204, LEXINGTON, KY 40502-3400
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4226A
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN9303664
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113064500
—
FL
05
—
74007352
—
KY
Enumeration date
08/12/2005
Last updated
04/14/2023
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