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1629611751
ANDREA JO TACKETT
ASHLAND, KY
NPI
1629611751
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner Adult Health
(Licence: KY 3013898)
Enumeration Date
2019-10-22
Last Update Date
2020-09-15
Business Address
ANDREA JO TACKETT APRN
2500 STATE ROUTE 5
ASHLAND, KY 41102-9102
Phone number: 606-408-4000
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Mailing Address
ANDREA JO TACKETT APRN
PO BOX 1595
ASHLAND, KY 41105-1595
Phone number: 606-408-9571
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