| NPI Details | |
|---|---|
| NPI | 1770890501 |
| Gender | Female |
| Enumeration Date | 08/31/2010 |
| Last Updated | 08/31/2010 |
| Entity Type | Individual |
| Active | Over 6 years ago |
| Practice Location | |
|---|---|
| 401 6TH AVE MONTGOMERY WV, 25136-2116, US |
|
| Phone | (304) 442-8381 |
| Fax | |
| Business Location | |
|---|---|
| 401 6TH AVE MONTGOMERY WV, 25136-2116, US |
|
| Phone | (304) 442-8381 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 363LF0000X |
| License State | West Virginia |
| License Number | 50951 |
| Remove 1770890501 NPI Number | |
According to our database, Krista Kay Tackman FNP-BC NPI is 1770890501, taxonomy code is 363LF0000X and license number is 50951, license state is located at West Virginia. Krista Kay Tackman FNP-BC physically located at 401 6th Ave, Montgomery WV, 25136-2116. NPI Number Krista Kay Tackman FNP-BC has the Individual type.
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1770890501 NPI number is provided on an as is basis without warranty of any kind. 1770890501 is maintained by the National Plan & Provider Enumeration System. The contents of Krista Kay Tackman FNP-BC are for informational purposes only.
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