Taggart, Jack

Taggart, Jack is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-6514. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Taggart, Jack can be contacted via phone (352) 273-8610.

Contact Information

Primary practice address
1600 Sw Archer Rd Gainesville FL 32610-6514
Phone: (352) 273-8610
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APRN9303664 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4226A Kentucky

Profile Details

NPI number 1457353120
LBN Legal business name Taggart, Jack
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Apr 14th, 2023 - about 2 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 1457353120 NPPES
Kentucky MEDICAID 74007352
Kentucky MEDICAID 113064500

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