Individual
JORDAN RYAN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
500 LAUCHWOOD DR, LAURINBURG, NC 28352-5501
(910) 277-9164
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5017840
NC
Other
Enumeration date
04/10/2023
Last updated
07/15/2024
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