Individual
NATALIE DANIELLE TACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2800 GODWIN BLVD FL 1, SUFFOLK, VA 23434-8038
(757) 934-4821
(757) 934-4276
Mailing address
2800 GODWIN BLVD FL 1, SUFFOLK, VA 23434-8038
(757) 934-4821
(757) 934-4276
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024171821
VA
Other
Enumeration date
08/14/2014
Last updated
05/08/2024
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