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Individual
KATIE H TUCK
Active
Individual
KATIE H TUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1072378
AL
363LA2200X
Adult Health Nurse Practitioner
1-072378
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051542593
BCBS
AL
05
—
891017461
—
AL
01
—
Z08424
VIVA
AL
Enumeration date
08/17/2007
Last updated
09/08/2014
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