Individual
MS. BETTY JEAN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
46 UTZ ST, FREEPORT, NY 11520
(516) 208-3524
(516) 208-3524
Mailing address
46 UTZ ST, FREEPORT, NY 11520
(516) 208-3524
(516) 208-3524
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
290418
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02263207
—
NY
Enumeration date
01/07/2008
Last updated
01/07/2008
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