IndividualActive
Benjamin Tackett, FNP
NPI 1265959704 · Family Nurse Practitioner · Logan, WV
Provider details
- NPI number
- 1265959704
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- FNP
- Sex
- Male
- Sole proprietor
- No
- License
- 66717 (WV)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
140 Stollings Ave Ste 1
Logan, WV 25601-4035
Phone: (304) 752-2555
Approximate (ZIP-level) locationGet directions
Mailing address
140 Stollings Ave Ste 1
Logan, WV 25601-4035
Registry dates
- Enumerated
- 2017-08-25
- Last updated
- 2017-08-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.