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Individual

MRS. SHEILA M TUCK

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
523 ANDREWS DR, HAMPTON, GA 30228-3424
(770) 471-3381
Mailing address
523 ANDREWS DR, HAMPTON, GA 30228-3424
(770) 471-3381

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN062738
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPN062738
STATE OF GA LPN LICENSE
GA
Enumeration date
05/04/2006
Last updated
07/08/2007
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