Individual
NANCY SUE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1055 SAXON BLVD, ORANGE CITY, FL 32763-8468
(386) 943-4522
Mailing address
PO BOX 9430, DAYTONA BEACH, FL 32120-9430
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME68449
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27879
BLUE CROSS
FL
Enumeration date
06/01/2006
Last updated
02/01/2008
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