Individual
MISS CHARNITA NICOLE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
934 W 14TH ST, LORAIN, OH 44052-3549
(440) 654-2262
Mailing address
934 W 14TH ST, LORAIN, OH 44052-3549
(440) 654-2262
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400895530409
OH
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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