| NPI | 1821038993 |
|---|---|
| Former Name | CAROLYN JEAN TUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 130847) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 130847) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 130847) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 130847) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2023-02-09 |