KRISTA KAY TACKMAN (NPI# 1770890501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770890501 |
| Entity Type | Individual |
| Full Name | KRISTA KAY TACKMAN |
| Credential | FNP-BC |
| Practice Address |
401 6th Ave Montgomery WV 25136-2116 |
| Practice Telephone | 3044428381 |
| Mailing Telephone | 3044428381 |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2010-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
50951 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
401 6TH AVE |
| City | MONTGOMERY |
| State | WV |
| Zip Code | 25136-2116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144226424 | Fred L Akerberg | Family Medicine | 401 6th Ave, # D303, Montgomery, WV 25136-2116 | 2005-06-22 |
| 1275163644 | Montgomery Physicians Clinic | Family Medicine | 401 6th Ave, Montgomery, WV 25136-2116 | 2020-01-24 |
| 1548890221 | Montgomery Pediatrics | Pediatrics | 401 6th Ave, Montgomery, WV 25136-2116 | 2020-01-22 |
| 1023671310 | Kara Shae Criswell | Pediatrics | 401 6th Ave, Montgomery, WV 25136-2116 | 2019-04-22 |
| 1043672884 | Aaron Bailey | Physician Assistant | 401 6th Ave, Montgomery, WV 25136-2116 | 2016-03-22 |
| 1013372531 | Montgomery Gen Cahgrp | Family Medicine | 401 6th Ave, Montgomery, WV 25136-2116 | 2015-12-29 |
| 1992100010 | Montgomery Gen Cahgrp | Family Medicine | 401 6th Ave, Montgomery, WV 25136-2116 | 2014-10-31 |
| 1831503655 | Ghassan Y. Dagher | Optometrist | 401 6th Ave, Suite 110, Montgomery, WV 25136-2116 | 2014-06-19 |
| 1891108502 | Katie Carpenter | Physician Assistant | 401 6th Ave, Montgomery, WV 25136-2116 | 2014-06-10 |
| 1184041865 | Laura Sheets | Occupational Therapy Assistant | 401 6th Ave, Montgomery, WV 25136-2116 | 2014-03-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861618738 | Saghir Ur Rehman Mir | Orthopaedic Surgery | 401 6th Avenue, Suite 302, Montgomery, WV 25136 | 2007-04-18 |
| 1871684324 | Montgomery General Hospital, Inc. | Skilled Nursing Facility | 401 Sixth Avenue, Montgomery, WV 25136 | 2006-09-28 |
| 1124070149 | Adin Lim Timbayan | General Practice | 411 Washington St, Montgomery, WV 25136 | 2006-05-17 |
| 1902350275 | Willard Truman Long Jr. | Social Worker | 410 Ferry St, Montgomery, WV 25136 | 2016-08-04 |
| 1922160787 | Adin L Timbayan Md Inc | General Practice | 411 Washington St, Montgomery, WV 25136 | 2006-12-15 |
| 1245281195 | Victoria Santos Timbayan | General Practice | 411 Washington St, Montgomery, WV 25136 | 2006-05-15 |
| 1063591816 | Karon Rae Myers | Registered Nurse | 401 Sixth Avenue, Montgomery General Hospital, Montgomery, WV 25136-0270 | 2006-11-03 |
| 1467614933 | Arpan Kohli | Student in an Organized Health Care Education/Training Program | 420 3rd Ave, Montgomery, WV 25136-2101 | 2008-06-26 |
| 1437525714 | Bio-medical Applications of West Virginia, Inc. | Clinic/Center | 506 3rd Ave, Montgomery, WV 25136-2102 | 2015-08-20 |
| 1447311451 | Kennedy Dental Office | Dentist | 410 4th Ave, Montgomery, WV 25136-2105 | 2006-12-13 |
| Find all providers in zip 25136 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184240285 | Miranda Michelle Roach | Nurse Practitioner | 11907 Candlewood Pl, Montgomery, TX 77356-5427 | 2020-06-24 |
| 1508416611 | Casey Thornton | Nurse Practitioner | 370 Saint Lukes Dr, Montgomery, AL 36117-7111 | 2019-09-19 |
| 1558917047 | Brittany Ann Smith | Nurse Practitioner | 1722 Pine St Ste 904, Montgomery, AL 36106-1104 | 2019-08-12 |
| 1952956567 | Cassandra Aileen Kelley | Nurse Practitioner | 1722 Pine St Ste 401, Montgomery, AL 36106-1103 | 2019-08-09 |
| 1982264867 | Bethany Fain Phelps | Nurse Practitioner | 1722 Pine St Ste 402, Montgomery, AL 36106-1159 | 2019-06-13 |
| 1447813027 | Haley Harvey Clifton | Nurse Practitioner | 1758 Park Pl Ste 401, Montgomery, AL 36106-1135 | 2019-04-18 |
| 1861958241 | Tameka Lene' Myles | Nurse Practitioner | 2905 East South Boulevard, Montgomery, AL 36116 | 2019-02-11 |
| 1780162024 | Grace Santana | Nurse Practitioner | 3270 Gatsby Ln, Montgomery, AL 36106-2668 | 2018-07-30 |
| 1013494673 | Angela K Rayborn | Nurse Practitioner | 1725 W 4th St # Na, Montgomery, AL 36106-1509 | 2018-07-25 |
| 1942795430 | Richard Yullambo Yenkong | Nurse Practitioner | 2270 Jericho Rd Apt A5, Montgomery, IL 60538-5621 | 2018-06-27 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 25136 |
Please comment or provide details below to improve the information on KRISTA KAY TACKMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.