| NPI | 1508535154 |
|---|---|
| Former Name | AYANNA TUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: PA SP024193) |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2021-11-05 |