Individual
STACY MARIE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1150 BROOKSIDE AVE STE U, REDLANDS, CA 92373-6304
(909) 335-4131
Mailing address
1150 BROOKSIDE AVE STE U, REDLANDS, CA 92373-6304
(909) 335-4131
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
662818
CA
163WD0400X
Diabetes Educator Registered Nurse
Primary
662818
CA
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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