Individual provider · Type 1 NPI

Jeffery Ray Tackett, APRN, PPCNP-C

Pediatric Nurse Practitioner · Las Vegas, NV

NPI number 1376956789 Active

Practice location

2650 N Tenaya Way Ste 308
Las Vegas, NV 89128-1102

Call (702) 870-2099 Map

Fax (702) 869-5347

Mailing address

6355 S Buffalo Dr Fl 3
Las Vegas, NV 89113-2133

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner 363LP0200X18745 (TN)
Pediatric Nurse Practitioner Primary 363LP0200XAPRN002155 (NV)

Pediatric Nurse Practitioner: Definition to come...

2 other providers at this address

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About NPI 1376956789

Jeffery Ray Tackett, APRN, PPCNP-C's National Provider Identifier is 1376956789, issued on Jun 4, 2014. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Las Vegas, NV. The record was last updated on Nov 3, 2022.