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Benjamin Tackett, FNP
Family Nurse Practitioner in Logan, West Virginia
NPI 1265959704

Benjamin Tackett is a Family Nurse Practitioner based in Logan, WV and is specialized in Family. Benjamin Tackett practices in Logan, WV and has the professional credentials of FNP. The NPI Number for Benjamin Tackett is 1265959704 and holds a License No. 66717 (West Virginia).

The current practice location address for Benjamin Tackett is 140 Stollings Ave Ste 1, Logan, WV and can be reached out via phone at 304-752-2555.

Location: 140 Stollings Ave Ste 1, Logan, WV, 25601-4035
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265959704
Provider Name
Benjamin Tackett
Credential
FNP
Provider Entity Type
Individual
Gender
Male
Address
140 Stollings Ave Ste 1, Logan, WV, 25601-4035
Phone Number
304-752-2555
Fax Number
Provider Enumeration Date
08/25/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
140 Stollings Ave Ste 1
City
Logan
State
West Virginia
Zip
25601-4035
Phone Number
304-752-2555
Fax Number
person
Provider Business Mailing Address Details
Address
140 Stollings Ave Ste 1
City
Logan
State
West Virginia
Zip
25601-4035
Phone Number
304-752-2555
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
66717 (West Virginia)
Definition
Definition to come...
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