| Doctor Name: | MRS. JOAN LAVONNE TACKETT |
| NPI Number: | 1154697829 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | A03553ANP |
| Business Practice Address: | 305 W. Front St.. Sherwood Urgent Care Lonoke, AR - 72086 |
| Business Phone Number: | 5016766560 |
| Business Fax Number: | 5016767166 |
| Mailing Address: | 305 W. Front St.., Sherwood Urgent Care LONOKE |
| State: | AR |
| Postal Code: | 72086 |
| Phone Number: | 5016766560 |
| Fax Number: | 5016767166 |
| NPI Enumeration Date: | 03/28/2012 |
| NPI Last Update Date: | 03/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A03553ANP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |