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1063871994
EMILY JANE TACKETT
AUSTELL, GA
NPI
1063871994
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Former Name
EMILY JANE ALLEN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: GA RN204462)
Enumeration Date
2016-02-20
Last Update Date
2016-02-20
Business Address
Mrs. EMILY JANE TACKETT CPNP
3950 AUSTELL RD
AUSTELL, GA 30106-1121
Phone number: 470-732-5201
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Mailing Address
Mrs. EMILY JANE TACKETT CPNP
3950 AUSTELL RD
AUSTELL, GA 30106-1121
Phone number: 470-732-5201
Copy
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