Individual
HELEN TACKITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
302 W GRAHAM ST, MEBANE, NC 27302-2312
(919) 568-0004
Mailing address
302 W GRAHAM ST, MEBANE, NC 27302-2312
(919) 568-0004
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
226622
NC
363LF0000X
Family Nurse Practitioner
RN.430379
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2593350
MEDICARE
—
05
—
7004396
—
NC
Enumeration date
10/17/2006
Last updated
12/30/2022
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