Tackett, Rebecca L

Tackett, Rebecca L is an individual health care provider with primary practice located at 1955 Dixie Hwy Suite D, Ft Wright KY 41011-2792. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Tackett, Rebecca L can be contacted via phone (859) 341-5757.

Contact Information

Primary practice address
1955 Dixie Hwy Suite D Ft Wright KY 41011-2792
Fax: (859) 426-7134
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3003239 Kentucky

Profile Details

NPI number 1447277934
LBN Legal business name Tackett, Rebecca L
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Feb 5th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447277934 NPPES
Kentucky MEDICAID 78005840

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