Tackett, Tamara L

Tackett, Tamara L is an individual health care provider with primary practice located at 101 E Wood St Suite 401, Spartanburg SC 29303-3040. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Tackett, Tamara L can be contacted via phone (864) 560-6654.

Contact Information

Primary practice address
101 E Wood St Suite 401 Spartanburg SC 29303-3040
Phone: (864) 560-6654
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4459 South Carolina

Profile Details

NPI number 1861797151
LBN Legal business name Tackett, Tamara L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2011
Last updated Apr 15th, 2013 - about 13 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 1861797151 NPPES
South Carolina MEDICAID NP1776

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