NIKITA DERYABIN TUCKER

CAMP LEJEUNE, NC
NPI1619704152
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
(Licence: NC  12222246ND)
Enumeration Date2024-09-18
Last Update Date2024-09-18
Business Address
NIKITA DERYABIN TUCKER
PSC BOX 20183
CAMP LEJEUNE, NC 28542-0183
Phone number: 910-440-7704
Mailing Address
NIKITA DERYABIN TUCKER
PSC BOX 20183
CAMP LEJEUNE, NC 28542
Phone number:
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