JESSICA TACKABERRY MSN, FNP-BC
NPI 1215704184
Nurse Practitioner in Warren, MI

Q: What is Jessica Tackaberry's NPI number?

The NPI number for Jessica Tackaberry is 1215704184. It was assigned to this individual provider in the NPPES registry on December 11, 2023.

Q: What is Jessica Tackaberry's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since December 11, 2023

31051 GARDENDALE DR, WARREN, MI 48088(586) 350-6512 Get Directions Write a Review

NPPES record last updated: December 11, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jessica Tackaberry Msn, Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA TACKABERRY MSN, FNP-BC (NPI 1215704184) is an individual nurse practitioner in Warren, Michigan, licensed in Michigan (4704296939) and active in the NPI registry since December 2023.

NPPES Registry Identity

NPI1215704184

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameJESSICA TACKABERRYCredential: MSN, FNP-BC

Location Address31051 GARDENDALE DRWarren, MI 48088-2056

Mailing Address31051 Gardendale DrWarren, MI 48088-2056

Phone(586) 350-6512

Sole ProprietorNo

Enumeration DateDecember 11, 2023

NPPES CertifiedDecember 10, 2023

✔ NPI 1215704184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MI · 4704296939

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

31051 GARDENDALE DR, Warren, MI 48088

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Tackaberry's NPI number?

The NPI number for Jessica Tackaberry is 1215704184. It was assigned to this individual provider in the NPPES registry on December 11, 2023.

Where is Jessica Tackaberry located?

Jessica Tackaberry practices at 31051 Gardendale Dr, Warren, MI 48088. The listed phone number is (586) 350-6512.

What is Jessica Tackaberry's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Jessica Tackaberry was last updated on December 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.