Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. SUSAN DENISE TACKETT, CPED
Active Sole ProprietorMRS. SUSAN DENISE TACKETT, CPED is a Contractor healthcare provider located in MONROE, Georgia. NPI 1063505352 is currently active in the NPPES registry. Verify at CMS.
Contractor · MONROE, GA
Registration Details
- NPI Number
- 1063505352
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 1, 2006 (19.847168778624 yrs)
- Last Updated
- Jul 8, 2007
- Sole Proprietor
- Yes
Practice Information
- Address
-
696 BREEDLOVE DRSUITE B5MONROE, GA, 306552052Browse GA providers · Browse ZIP 30655
- Phone
- 4047137011
- Fax
- 7702077196
- Primary Specialty
-
Contractor
171W00000X
Other Contractor Providers in MONROE, GA
| Name | Credential | NPI |
|---|---|---|
| KIMBERLY NICOLE GILES | — | 1396823225 |
| DANIELLE PARKS | — | 1134793029 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.