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Contact Information

TANYA TACKETT
840 INTERSTATE DR
GRAYSON, KY41143-1768
 Phone: 606-474-5151
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Licensed Practical Nurse

164W00000X
 

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for TANYA TACKETT · (Female)

NPI # 1770224982
Status Active
Credentials
Entity Individual
Enumeration date 04/05/2022
Last updated 02/28/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • KY License # 2039581
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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