Individual
GENNIE LOU TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1840 AMHERST ST, WINCHESTER, VA 22601-2808
(540) 536-8000
Mailing address
220 CAMPUS BLVD STE 100, WINCHESTER, VA 22601-2888
(540) 536-5100
(540) 536-0235
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024174010
VA
367500000X
Certified Registered Nurse Anesthetist
1-061334
AL
367500000X
Certified Registered Nurse Anesthetist
20621
SC
367500000X
Certified Registered Nurse Anesthetist
280661
NC
367500000X
Certified Registered Nurse Anesthetist
APN15760
TN
367500000X
Certified Registered Nurse Anesthetist
RN181133
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003110310A
—
GA
05
—
1523879
—
TN
01
—
4295481
BLUE CROSS BLUE SHIELD OF TN
TN
01
—
P00944106
RAILROAD MEDICARE
—
05
—
PENDING
—
SC
Enumeration date
02/20/2008
Last updated
02/07/2020
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