MS. STACY ANN TACKETT RN ANP-BC NPI 1972805281

NPI Information

NPI: 1972805281
Provider Name: MS. STACY ANN TACKETT, RN, ANP-BC
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: HEALTHTEXAS PROVIDER NETWORK

PECOS Registration: Yes

Address:
3600 GASTON AVE
BARNETT TOWER, STE 605
DALLAS, TX
ZIP 75246
Phone: (214) 820-9248
Get Directions

MS. Stacy Ann Tackett, RN, ANP-BC is an adult health nurse practitioner in Dallas, TX with 14 years of experience. MS. Stacy Ann Tackett, RN, ANP-BC NPI is 1972805281. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3600 GASTON AVE
BARNETT TOWER, STE 605
DALLAS, TX
ZIP 75246-800
Phone: (214) 820-9248
Fax: (214) 820-9258

The NPI 1972805281 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/19/2010 and was last updated on 5/8/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	595007	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3126120-01	MEDICAID	TEXAS
2	264494YKY6	MEDICARE PIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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