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1710104716
ROBERTA TACKETT
CORBIN, KY
NPI
1710104716
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: KY 3002865)
Enumeration Date
2007-04-19
Last Update Date
2011-03-29
Business Address
-- ROBERTA TACKETT APRN, RN
1203 AMERICAN GREETING RD
CORBIN, KY 40701-4811
Phone number: 606-528-7010
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Mailing Address
-- ROBERTA TACKETT APRN, RN
PO BOX 568
CORBIN, KY 40702-0568
Phone number:
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