Tackett, Tamara L
Tackett, Tamara L is an individual health care provider with primary practice located at 101 E Wood St Suite 401, Spartanburg SC 29303-3040. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Tackett, Tamara L can be contacted via phone (864) 560-6654.Contact Information
Primary practice address
101 E Wood St Suite 401
Spartanburg SC 29303-3040
Phone: (864) 560-6654
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 4459 | South Carolina |
Profile Details
NPI number | 1861797151 |
---|---|
LBN Legal business name | Tackett, Tamara L |
Credentials | Nurse Practitioner (NP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 18th, 2011 |
Last updated | Apr 15th, 2013 - about 12 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1861797151 | NPPES |
South Carolina | MEDICAID | NP1776 |
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