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Individual

MISS AUGUSTA HAWA TUCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
6700 BELCREST RD, APT 321, HYATTSVILLE, MD 20782-1398
(240) 305-4234
Mailing address
6700 BELCREST RD, APT 321, HYATTSVILLE, MD 20782-1398
(240) 305-4234

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP43064
MD
164W00000X
Licensed Practical Nurse
LPN1003906
DC

Other

Enumeration date
05/25/2012
Last updated
05/25/2012
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