| NPI | 1730432493 |
|---|---|
| Former Name | MICHELLE L TUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 677993) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2018-08-29 |