Tackett, Katrina

Tackett, Katrina is an sole proprietor health care provider with primary practice located at 637 A Mohawk Dr , Lucasville OH 45648-8985. She recently has only one registered license in Nursing Service Related Providers / Nurse's Aide, which is considered as her primary health care specialty. Tackett, Katrina can be contacted via phone (740) 250-6699.

Contact Information

Primary practice address
637 A Mohawk Dr Lucasville OH 45648-8985
Phone: (740) 250-6699
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Nurse's Aide 376K00000X Ohio

Profile Details

NPI number 1922766583
LBN Legal business name Tackett, Katrina
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 1st, 2021
Last updated Dec 1st, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922766583 NPPES
Ohio MEDICAID 591052

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