Individual provider · Type 1 NPI

Megan Tackett

Medical Physician Assistant · St. Petersburg, FL

NPI number 1619873072 Active

Practice location

201 17th St S Apt 1122
St. Petersburg, FL 33712-1741

Call (606) 269-5633 Map

Mailing address

201 17th St S
St. Petersburg, FL 33712-1710

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1619873072

Megan Tackett's National Provider Identifier is 1619873072, issued on Oct 14, 2026. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in St. Petersburg, FL. The record was last updated on Oct 14, 2026.