Individual provider · Type 1 NPI

Andrea Jo Tackett, APRN

Adult Health Nurse Practitioner · Ashland, KY

NPI number 1629611751 Active

Practice location

2500 State Route 5
Ashland, KY 41102-9102

Mailing address

PO Box 1595
Ashland, KY 41105-1595

Other practice locations

  • 250 Mcdavid Blvd, Grayson, KY 41143-1603 · (606) 474-7835

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200X3013898 (KY)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1629611751

Andrea Jo Tackett, APRN's National Provider Identifier is 1629611751, issued on Oct 22, 2019. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Ashland, KY. The record was last updated on Sep 15, 2020.