MS. Mary Brooke Tackett Wyatt, PA
NPI #1821286519 in Crossville, Tennessee
Provider Information
- NPI Number
- 1821286519
- Entity Type
- Individual
- Name
- MS. Mary Brooke Tackett Wyatt, PA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PA
- Enumeration Date
- Oct 9, 2007
- Last Updated
- Sep 18, 2025
Practice Location
- Address
- 1645 S MAIN ST
- Address 2
- SUITE 101
- City
- Crossville
- State
- Tennessee
- ZIP Code
- 38555-2908
- Phone
- (931) 484-7531
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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