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Individual
MRS. SUSAN ANN TUCKEY
Active
Individual
MRS. SUSAN ANN TUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., C.P.N.P.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.245460
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
209.002268041.245460
IL
Other
Enumeration date
12/14/2010
Last updated
12/14/2010
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