Individual
LISA F TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
611 W PARK ST, NEONATOLOGY, URBANA, IL 61801-2500
(217) 383-3266
(217) 383-3463
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
277002328
IL
Other
Enumeration date
10/05/2011
Last updated
10/15/2024
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