Individual
MS. JUDITH ANN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 882-3007
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 882-3007
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002552-1
NY
363A00000X
Physician Assistant
Primary
MA001022L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA0598
MEDICARE GROUP
NY
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039812
PA MEDICARE GROUP
PA
Enumeration date
02/24/2006
Last updated
03/28/2008
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