Organization
TUCKER ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL K TUCKER CRNA (SOLE MEMBER)
(952) 442-9770
Entity
Organization
Contact information
Practice address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-3613
(952) 442-3620
Mailing address
PO BOX 408, 130 E LOCKLING, BROOKFIELD, MO 64628-0408
(952) 442-9770
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
06/23/2008
Last updated
06/23/2008
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