MS. Jeanine Marie Tackla, APRN, MSN, A-GNP-C
MS. Jeanine Marie Tackla, APRN, MSN, A-GNP-C is a Nurse Practitioner in Keller, Texas. Qualified in 2022, 4 years ago. Practices with Lakeway Medical Clinic LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Illinois and Texas.
- Years since qualifying
- 4
- Licensed in
- IL, TX
- In the registry since
- 2011
- Specialties on file
- 2
What do these letters mean?
Practice location Address checks out
8739 Davis Blvd Ste 100Keller, TX 76248-0309
Phone: (817) 476-1226
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Gerontology Nurse Practitioner (primary) | Taxonomy 363LG0600X · Licence 1114749 (TX) |
|---|---|
| Registered Nurse First Assistant | Taxonomy 163WR0006X · Licence 095692 (IL) |
Record details
| NPI number | 1255612537 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | APRN , MSN , A-GNP-C |
| Sole proprietor | Yes |
| NPI enumerated | August 31, 2011 |
| Last updated in NPPES | March 17, 2026 |
| Certification date | March 17, 2026 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2022 (4 years in practice) |
| Group practice | Lakeway Medical Clinic Llc — 3 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 3 on file with Medicare |