Individual
SHAKEMA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10543 S CRATER RD, SOUTH PRINCE GEORGE, VA 23805-7333
(800) 805-6989
Mailing address
9183 COUNTY DR, DISPUTANTA, VA 23842-6202
(804) 704-3432
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002080829
VA
Other
Enumeration date
03/10/2022
Last updated
03/10/2022
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