Krista Kay Tackman FNP-BC

NPI 1770890501 - Nurse Practitioner - 363LF0000X

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
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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.