Individual
CHADWICK TREI TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, FNP
Contact information
Practice address
230 W MAIN ST, LEXINGTON, KY 40507-1340
(859) 309-4839
Mailing address
728 FITZROY LN, LEXINGTON, KY 40515-6354
(606) 255-7466
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1135877
KY
363LF0000X
Family Nurse Practitioner
Primary
3013650
KY
Other
Enumeration date
04/08/2019
Last updated
02/04/2022
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