IndividualActive
Jeffery Tackett, APRN, PPCNP-C
NPI 1376956789 · Pediatric Nurse Practitioner · Las Vegas, NV
Provider details
- NPI number
- 1376956789
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN, PPCNP-C
- Sex
- Male
- Sole proprietor
- No
- License
- 18745 (TN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2650 N Tenaya Way Ste 308
Las Vegas, NV 89128-1102
Phone: (702) 870-2099
Fax: (702) 869-5347
Approximate (ZIP-level) locationGet directions
Mailing address
6355 S Buffalo Dr Fl 3
Las Vegas, NV 89113-2133
Registry dates
- Enumerated
- 2014-06-04
- Last updated
- 2022-11-03
- Certified
- 2022-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.