Individual
TASHA RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2372 US49-E, SUMNER, MS 38957
(662) 375-9310
Mailing address
744 CATALPA ST, CLARKSDALE, MS 38614-3118
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904227
MS
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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