Individual
LISA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5108
(405) 424-7711
Mailing address
6308 N HARMON DR, WARR ACRES, OK 73122-7354
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0066569
OK
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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