Jeanine Marie Tackla, APRN, MSN, A-GNP-C,

Nurse practitioner in Keller, Texas · NPI 1255612537

Jeanine Tackla is one of 54 nurse practitioners practicing in Keller, Texas. Jeanine Tackla practices with Lakeway Medical Clinic LLC.

Registry record (NPPES)

NPI
1255612537
Type
Type 1 · Individual
Primary taxonomy
Nurse Practitioner, Gerontology · 363LG0600X
Address on file
8739 Davis Blvd Ste 100
Keller, TX 76248-0309
(817) 476-1226
Enumerated
Aug 31, 2011
Record last updated
Mar 17, 2026
License states listed
IL, TX

Medicare (CMS)

Enrollment
Medicare-enrolled in TX
Nurse Practitioner
Revalidation due
No date set by CMS

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Practice locations

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Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.