# BRONYA KAY TUCKER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1972745156
- **Gender:** F
- **Credential:** NP-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | 50676 | WV | — |
| 363LF0000X | Family Nurse Practitioner | 50676 | WV | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 50676 | WV | Yes |

## Other

- **Enumeration date:** 04/02/2009
- **Last updated:** 11/18/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 50676 | LICENSE | WV |