ROBERTA TACKETT APRN RN NPI 1710104716

NPI Information

  • NPI: 1710104716
  • Provider Name: ROBERTA TACKETT, APRN, RN
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 1203 AMERICAN GREETING RD
    CORBIN, KY
    ZIP 40701
  • Phone: (606) 528-7010

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NPI Details

Roberta Tackett, APRN, RN is a psychiatric/mental health nurse practitioner in Corbin, KY. Roberta Tackett, APRN, RN NPI is 1710104716. 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:

1203 AMERICAN GREETING RD
CORBIN, KY
ZIP 40701-811
Phone: (606) 528-7010

The enumeration date for this NPI number is 4/19/2007 and was last updated on 3/29/2011.

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
1363LP0808XNurse PractitionerPsychiatric/Mental Health3002865KENTUCKYYes

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
10001375MEDICARE UPINKENTUCKY
20295609MEDICARE UPINKENTUCKY
30354112MEDICARE UPINKENTUCKY
40354506MEDICARE UPINKENTUCKY
50354908MEDICARE UPINKENTUCKY
60753803MEDICARE UPINKENTUCKY
70354317MEDICARE UPINKENTUCKY
80355709MEDICARE UPINKENTUCKY
90354807MEDICARE UPINKENTUCKY

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: 11/21/2025

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