Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Susan Denise Tackett, CPED

Individual provider Contractor · NPI 1063505352

Mrs. Susan Denise Tackett, CPED is a Contractor in Monroe, Georgia. Practices as a sole proprietor. Registered with an NPI since 2006.

In the registry since
2006
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Practice location Address checks out

696 Breedlove Dr Ste B5
Monroe, GA 30655-2052
Phone: (404) 713-7011
Fax: (770) 207-7196
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X

Record details

NPI number1063505352
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPED
Sole proprietorYes
NPI enumeratedOctober 1, 2006
Last updated in NPPESJuly 8, 2007

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