Individual
KATHERINE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11660 ROUND LAKE BLVD NW, COON RAPIDS, MN 55433-2638
(212) 217-3467
Mailing address
2203 N FERRY ST, ANOKA, MN 55303-6751
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/15/2026
Last updated
01/15/2026
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