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Individual

SHERI LYNNE TACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNP

Contact information

Practice address
133 ROUTE 3, DEDEDO, GU 96929
(671) 645-5500
Mailing address
133 ROUTE 3, DEDEDO, GU 96929-6911
(671) 645-5500

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RE1896
GU
176B00000X
Midwife
1177
AK
176B00000X
Midwife
NP0130
GU
363LF0000X
Family Nurse Practitioner
1177
AK
363LF0000X
Family Nurse Practitioner
Primary
NP0130
GU
363LN0005X
Critical Care Neonatal Nurse Practitioner
RE1896 / NP0130
GU

Other

Enumeration date
11/23/2010
Last updated
11/08/2018
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