Individual
ELIZABETH S TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94-450 MOKUOLA ST # SY, WAIPAHU, HI 96797-3388
(808) 944-2882
Mailing address
86-220 LEILEHO PL, WAIANAE, HI 96792-2993
(442) 247-9053
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
0419-34
HI
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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