Individual
NELLIE SUSAN TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
921 NE 13TH ST, NFS 120, OKLAHOMA CITY, OK 73104-5007
(405) 270-0501
(405) 297-5914
Mailing address
3775 CEDAR RIDGE DR, NORMAN, OK 73072-4622
(405) 573-1433
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
652
OK
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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