Individual
STEPHANIE R TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 THUNDERSTICK DR, LEXINGTON, KY 40505-9010
(859) 254-1035
Mailing address
2250 THUNDERSTICK DR, LEXINGTON, KY 40505-9010
(859) 254-1035
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
KY
Other
Enumeration date
12/19/2025
Last updated
01/20/2026
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