Individual
IESHA MARLENA TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
510 N MAIN ST, ROCKY TOP, TN 37769-2818
(865) 205-9582
(865) 205-9583
Mailing address
2205 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2904
(423) 352-6500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
27010
TN
Other
Enumeration date
02/03/2020
Last updated
11/28/2022
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