Mrs Jeni Diane Tackett, RD is a
Dietitian, Registered based in East Moline, Illinois. Mrs Jeni Diane Tackett is licensed to practice in Iowa (license number 876463) and her current practice location is
3928 172nd St N, East Moline, Illinois. She can be reached at her office (for appointments etc.) via phone at
(309) 230-9517.
NPI number for Mrs Jeni Diane Tackett is 1366819690 and her current mailing address is 3928 172nd St N, East Moline, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1366819690.
Healthcare Provider's Profile
Full Name | Mrs Jeni Diane Tackett |
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Gender | Female |
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Speciality | Dietitian, Registered |
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Location | 3928 172nd St N, East Moline, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1366819690
- Provider Enumeration Date: 08/21/2015
- Last Update Date: 08/21/2015
Medical Identifiers
Medical identifiers for Mrs Jeni Diane Tackett such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1366819690 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | 876463 (Illinois) | Secondary |
133V00000X | Dietitian, Registered | 876463 (Iowa) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Jeni Diane Tackett is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Jeni Diane Tackett, RD 3928 172nd St N, East Moline, IL 61244-9728 Ph: (309) 230-9517 | Mrs Jeni Diane Tackett, RD 3928 172nd St N, East Moline, IL 61244-9728 Ph: (309) 230-9517 |
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