NPI Details | |
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NPI | 1770890501 |
Gender | Female |
Enumeration Date | 08/31/2010 |
Last Updated | 08/31/2010 |
Entity Type | Individual |
Active | Over 7 years ago |
Practice Location | |
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401 6TH AVE MONTGOMERY WV, 25136-2116, US |
|
Phone | (304) 442-8381 |
Fax |
Business Location | |
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401 6TH AVE MONTGOMERY WV, 25136-2116, US |
|
Phone | (304) 442-8381 |
Fax |
Toxanomy | |
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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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