| NPI | 1134888118 |
|---|---|
| Other Name | SUSAN TUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704310011) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704310011) |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2024-04-30 |